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1.
Artigo em Inglês | MEDLINE | ID: mdl-33922924

RESUMO

The COVID-19 pandemic has changed our lifestyles, habits, and daily routine. Some of the impacts of COVID-19 have been widely reported already. However, many effects of the COVID-19 pandemic are still to be discovered. The main objective of this study was to assess the changes in the frequency of reported physical back pain complaints reported during the COVID-19 pandemic. In contrast to other published studies, we target the general population using Twitter as a data source. Specifically, we aim to investigate differences in the number of back pain complaints between the pre-pandemic and during the pandemic. A total of 53,234 and 78,559 tweets were analyzed for November 2019 and November 2020, respectively. Because Twitter users do not always complain explicitly when they tweet about the experience of back pain, we have designed an intelligent filter based on natural language processing (NLP) to automatically classify the examined tweets into the back pain complaining class and other tweets. Analysis of filtered tweets indicated an 84% increase in the back pain complaints reported in November 2020 compared to November 2019. These results might indicate significant changes in lifestyle during the COVID-19 pandemic, including restrictions in daily body movements and reduced exposure to routine physical exercise.


Assuntos
Mídias Sociais , Dor nas Costas/epidemiologia , Humanos , Processamento de Linguagem Natural , Pandemias , Estados Unidos/epidemiologia
2.
BMC Geriatr ; 21(1): 229, 2021 04 07.
Artigo em Inglês | MEDLINE | ID: mdl-33827441

RESUMO

BACKGROUND: The proportion of older adults is increasing rapidly, and the majority are female. In 2050, the number of persons aged 60 years and over is estimated to reach 2.1 billion worldwide, constituting one-third of the total population of Europe. Long-term back pain is a disabling and common condition, primarily affecting older women. Although standardized functional evaluations are essential in the screening of older adults, self-rated activities of daily living capture a different aspect of the person's ability in the context of his or her environment and social support system. This study aimed to describe how older women with or without long-term back pain self-rate their activities of daily living (ADL) and instrumental activities of daily living (IADL) in relation to their performance-based testing of physical function, including walking test, leg muscle strength, balance, and endurance. METHOD: This study is part of the Gothenburg H70 Birth Cohort Studies in Sweden (H70 studies) and uses data from the 1944 birth cohort examined in 2015-16 at age 70. In the present study, only female participants were included in the analysis, and all cases of dementia (n = 17) and cases of acute and sub-acute back pain excluded (n = 181), leaving an effective sample of 446 female participants. RESULTS: Women with long-term back pain self-perceived their ADL and IADL as being as good as those without back pain, although they performed poorer in all performance-based tests and perceived themselves as less physically fit. CONCLUSION: The discrepancy between self-perceived functional ability (ADL/IADL) and performance-based testing of functioning based on clinical tests calls for further investigation to incentivize person-centered care in older women with long-term back pain in municipal or emergency health-care settings.


Assuntos
Atividades Cotidianas , Dor nas Costas , Idoso , Dor nas Costas/diagnóstico , Dor nas Costas/epidemiologia , Europa (Continente) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Suécia
3.
J Occup Health ; 63(1): e12208, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33682989

RESUMO

OBJECTIVES: Work-related musculoskeletal disorders (WMSDs) are common occupational injuries for nurses. Furthermore, rotating and irregular shift work may exacerbate muscle tension and pain in nurses. The objective of this study was to examine the differences between fixed day shift (FDS) nurses and rotating and irregular shift (RS + IS) nurses in WMSDs using a systematic literature review and meta-analysis. METHODS: Databases including PubMed, CINAHL, Cochrane Library, EBSCOhost, and Google Scholar were searched for relevant studies published between 2010 and 2020 using the target keywords. RESULTS: This study obtained data on a total of 18 199 nurses, among which 12 786 comprised the RS + IS group and 5413 constituted the FDS group. The result of the heterogeneity test was Q = 79.27 (P < .001) and I squared = 57.11%, indicating that heterogeneity existed among the studies. Subgroup analyses were also conducted with four groups: neck pain (n = 1818), shoulder and upper limb pain (n = 2525), back pain (n = 11 962), and hip and lower limb pain (n = 1894). Significant differences were found between the RS + IS group and the FDS group with regard to back pain, with the forest plot presenting an odds ratio equaling 1.40 (95% CI: 1.19-1.64, P < .001). CONCLUSIONS: This meta-analysis indicated that RS + IS nurses are more likely to experience back pain associated with WMSD than are FDS nurses. The results can serve as a reference to the clinical management for work improvement and thereby reduce or prevent the adverse effects of rotating and irregular shift work on back pain experienced by nurses.


Assuntos
Doenças Musculoesqueléticas/epidemiologia , Enfermagem , Doenças Profissionais/epidemiologia , Jornada de Trabalho em Turnos , Dor nas Costas/epidemiologia , Humanos , Extremidade Inferior , Cervicalgia/epidemiologia , Dor de Ombro/epidemiologia
4.
Artigo em Inglês | MEDLINE | ID: mdl-33535709

RESUMO

BACKGROUND: E-health tools have been used to assess the temporal variations of different health problems. The aim of our infodemiology study was to investigate the seasonal pattern of search volumes for back pain in Italy. METHODS: In Italian, back pain is indicated by the medical word "lombalgia". Using Google Trends, we selected the three search terms related to "lombalgia" with higher relative search volumes (RSV), (namely, "mal di schiena", "dolore alla schiena" and "dolore lombare"), representing the semantic preferences of users when performing web queries for back pain in Italy. Wikipedia page view statistics were used to identify the number of visits to the page "lombalgia". Strength and direction of secular trends were assessed using the Mann-Kendall test. Cosinor analysis was used to evaluate the potential seasonality of back pain-related RSV. RESULTS: We found a significant upward secular trend from 2005 to 2020 for search terms "mal di schiena" (τ = 0.734, p < 0.0001), "dolore alla schiena" (τ = 0.713, p < 0.0001) and "dolore lombare" (τ = 0.628, p < 0.0001). Cosinor analysis on Google Trends RSV showed a significant seasonality for the terms "mal di schiena" (pcos < 0.001), "dolore alla schiena" (pcos < 0.0001), "dolore lombare" (pcos < 0.0001) and "lombalgia" (pcos = 0.017). Cosinor analysis performed on views for the page "lombalgia" in Wikipedia confirmed a significant seasonality (pcos < 0.0001). Both analyses demonstrated a peak of interest in winter months and decrease in spring/summer. CONCLUSIONS: Our infodemiology approach revealed significant seasonal fluctuations in search queries for back pain in Italy, with peaking volumes during the coldest months of the year.


Assuntos
Dor nas Costas , Internet , Dor nas Costas/epidemiologia , Humanos , Itália/epidemiologia , Estações do Ano
5.
Cad Saude Publica ; 37(2): e00206019, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33624739

RESUMO

Our study aimed at assessing back pain impact over health-related quality of life (HRQoL). This is a cross-sectional population-based study that analyzed 1,192 adults. The dependent variables were the SF-36 scales and the main independent variables was back pain characterized by location, number of back pain region, intensity, frequency and limitations. Simple and multiple linear regression models were performed to estimate the crude and adjusted beta-coefficients (gender, age, schooling and co-morbidity conditions). Back pain prevalence were 35.4%. For HRQoL, comparing people with/without back pain, we found weak associations for the physical component (ß = -3.6). However, strong associations were found for physical component (ß = -12.4) when there were concomitant pain in cervical, dorsal and lumbar sites and also associations with mental health scales. Daily pain was associated with physical (ß = -6.8) and mental (ß = -2.7) components. Important impact on physical componente summary was found for intense/very intense pain (ß = -7.9) and pain with severe limitation (ß = -11.5). The impacts over HRQoL were strong when back pain was followed by (1) multiple back sites, (2) with pain in mental componente summary, (3) daily complaints, (4) very intense pain and (5) severe limitations; these results have revealed the importance to measure specific factors related to back pain.


Assuntos
Dor nas Costas , Qualidade de Vida , Adulto , Dor nas Costas/epidemiologia , Brasil/epidemiologia , Estudos Transversais , Humanos , Inquéritos e Questionários
6.
Artigo em Inglês | MEDLINE | ID: mdl-33498222

RESUMO

The prevalence of back pain (BP) among children and adolescents has increased over recent years. Some authors advocate promoting back-health education in the school setting. It is therefore important to adopt a uniform suite of assessment instruments to measure the various constructs. The present study aimed to perform a cultural adaptation of a validated measurement instrument (BackPEI), beginning with a translation and cultural adaptation phase, followed by a second phase to test reliability using a test-retest design. The translation and cross-cultural adaptation were performed based on the guidelines. Reliability was tested by applying the questionnaire to 224 secondary school students, at two different times with a 7-day interval between the tests. In general, the Spanish version presented adequate agreement for questions 1-20, with only question 9 achieving a low Kappa range of 0.312 (-0.152-0.189). The question about pain intensity did not show differences between the test means (4.72 ± 2.33) and re-test (4.58 ± 2.37) (p = 0.333), and the responses for these two tests obtained a high correlation (ICC = 0.951 (0.928-0.966); p = 0.0001). Psychometric testing indicated that the Spanish version of the BackPEI is well-adapted and reliable, based on the test-retest design, providing similar results to the original Brazilian version.


Assuntos
Dor nas Costas , Comparação Transcultural , Adolescente , Dor nas Costas/epidemiologia , Brasil , Criança , Humanos , Postura , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
8.
Spine (Phila Pa 1976) ; 46(1): 54-61, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33315364

RESUMO

STUDY DESIGN: Cross-sectional analysis of the Oxford Pain, Activity and Lifestyle (OPAL) Cohort Study. OBJECTIVE: The aim of this study was to assess the prevalence of back pain (BP) and leg pain and determine their relationship with adverse health states among older adults in England. SUMMARY OF BACKGROUND DATA: Epidemiological data describing the prevalence of BP and leg pain in older adults in England is lacking. METHODS: A total of 5304 community-dwelling adults (aged 65-100 years) enrolled in the OPAL cohort study who provided data on BP and leg pain were included. Participants were classified into four groups based on reports of back and leg pain: no BP, BP only, BP and leg pain which was likely to be neurogenic claudication (NC), and BP and leg pain which was not NC. Adverse health states were frailty, falls, mobility decline, low walking confidence, poor sleep quality, and urinary incontinence. We collected demographic and socioeconomic information, health-related quality of life, and existing health conditions, and estimated the association between BP presentations and adverse health states using regression analysis. RESULTS: Thirty-four percent of participants (1786/5304) reported BP only, 11.2% (n = 594/5304) reported BP and NC and 8.3% (n = 441/5304) reported BP and non-NC leg pain. Participants with BP had worse quality of life compared to those without BP. All BP presentations were significantly associated with adverse health states. Those with NC were most affected. In particular, there was greater relative risk (RR) of low walking confidence (RR 3.11, 95% confidence interval [CI] 2.56-3.78), frailty (RR 1.88, 95% CI 1.67-2.11), and mobility decline (RR 1.74, 95% CI 1.54-1.97) compared to no BP. CONCLUSION: Back and leg pain is a common problem for older adults and associated with reduced quality of life and adverse health states. Findings suggest a need to develop more effective treatment for older adults with BP especially for those with neurogenic claudication. LEVEL OF EVIDENCE: 2.


Assuntos
Dor nas Costas/epidemiologia , Dor Crônica/epidemiologia , Perna (Membro) , Acidentes por Quedas , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Estudos Transversais , Inglaterra/epidemiologia , Feminino , Fragilidade , Humanos , Vida Independente , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Prevalência , Qualidade de Vida
9.
J Surg Orthop Adv ; 29(3): 165-168, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33044158

RESUMO

The purpose of this study was to examine the relationship between smoking and back pain in a cross-sectional analysis. Using the Osteoarthritis Initiative database, a multi-center, longitudinal, observational cohort study with 4796 participants, we examined the prevalence of back pain and of limitations in activity due to back pain, as well as the frequency and severity of back pain in participants who were current smokers compared to those who had never smoked. Data was evaluated using binary and ordinal logistic regression analyses. An increase in prevalence, frequency and severity of back pain was strongly associated with smoking. This demonstrates a relationship between smoking and back pain; however, further studies are needed to evaluate causation. (Journal of Surgical Orthopaedic Advances 29(3):165-168, 2020).


Assuntos
Fumar Cigarros , Dor nas Costas/epidemiologia , Dor nas Costas/etiologia , Estudos Transversais , Humanos , Prevalência , Fumar/epidemiologia
10.
Artigo em Inglês | MEDLINE | ID: mdl-32635363

RESUMO

BACKGROUND: The prevalence of back pain in adolescents is steadily increasing, with negative repercussions on students' social and academic life. This study sought to improve the ergonomics and musculoskeletal health of adolescents in secondary school by implementing physiotherapy actions within the educational context. METHODS: A qualitative collaborative action research approach was used, comprising 49 students, 9 teachers, 11 family members, and 9 physiotherapists. Workshops on ergonomics, stretching, and massage were held. Visual materials were developed to support the assimilation of the information given at the workshops. Data collection included field notes, reflexive diaries, in-depth interviews, and discussion groups. The data were analyzed using the Atlas.ti 6.0 program (Scientific Software Development GmbH, Berlin, Germany). RESULTS: The presence of a physiotherapist in the school context facilitates the acquisition of healthy postural habits. All the adolescents perceived a decrease in back pain after undergoing the program. CONCLUSIONS: physiotherapy activities offer students new tools to decrease their back pain and improve their health.


Assuntos
Dor nas Costas/epidemiologia , Modalidades de Fisioterapia , Adolescente , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Instituições Acadêmicas , Espanha
11.
BMC Public Health ; 20(1): 805, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32471404

RESUMO

BACKGROUND: Children's health and welfare have a special place in research and policy in many countries. One of the most important concerns is the increasing rate of backache in children due to many of behavioral risk factors. The aim of this study was to evaluate the effectiveness of an educational program on promoting back-related behavior as well as knowledge, skills, beliefs, and self-efficacy among fifth grade girls. METHODS: The theory-based back care (T-Bak) study was a school-based randomised controlled trial (RCT) that assessed the effectiveness of developing a back care training program based on the social cognitive theory (SCT). A total of 104 schoolchildren aged 11 ± 1.0 years were assigned to intervention (n = 52) and control (n = 52) groups. The intervention group received six sessions training on proper lifting and carrying techniques, having proper posture during daily activities, and correct backpack wearing techniques with a 1-week interval while the control group received nothing. Then, the two groups were assessed for knowledge, skills, self-efficacy, beliefs, and behavior at four points in time: baseline, immediate, three and six-months post-intervention. The changes of the outcomes investigated using univariate repeated measures analysis of variance. Partial eta squared measure (ηp2) was used to calculate effect sizes. RESULTS: A positive change was found for the intervention group back-related behavior from baseline to immediate post-intervention and follow-ups (F = 78.865, p < 0.001, ηp2 = 0.22). Overall there were 36.4% improvement for knowledge (ηp2 = 0.21), 53.2% for the skills (ηp2 = 0.25), 19.5% for the self-efficacy (ηp2 = 0.11), and 25.6% for the beliefs (ηp2 = 0.14) scores from baseline to 6 months' follow-up assessments among the intervention group (p < 0.001). The results also showed a significant interaction effect between group and time. CONCLUSION: The T-Bak intervention was effective in improving back-related behavior in pupils. It is now available and could be evaluated further in back-care related studies. TRIAL REGISTRATION: Current Controlled Trials IRCT20180528039885N1, 30th Oct 2018, 'Prospectively registered'. https://www.irct.ir/trial/31534.


Assuntos
Dor nas Costas/terapia , Terapia Comportamental/educação , Terapia Comportamental/métodos , Promoção da Saúde/métodos , Educação de Pacientes como Assunto/métodos , Estudantes/estatística & dados numéricos , Dor nas Costas/epidemiologia , Terapia Comportamental/estatística & dados numéricos , Criança , Análise Custo-Benefício , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Instituições Acadêmicas
12.
PLoS One ; 15(4): e0231319, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32298295

RESUMO

BACKGROUND: Musculoskeletal disorder (MSD) is currently recognized as one of the most common occupational injuries for which nursing personnel in the medical service industry have been identified as a high-risk group. In this study, we explore the prevalence of MSD in various body parts as well as their risk factors among hospital nurses. METHODS: A cross-sectional descriptive design with stratified cluster sampling was used to collect data from 1,803 nurses. The survey included a demographic questionnaire, and Nordic Musculoskeletal Questionnaire. RESULTS: The results showed that the greatest prevalence of MSD symptoms by body regions were in the right shoulder (85.8%), the left shoulder (80.9%), the neck (62.4%), the right wrist (62.2%) and the lower back (60.4%). Risk factors for shoulder discomfort includes department type, exercise habits, and age (p < .05). Risk factors for neck discomfort includes seniority in the current unit, "job title, and "history of MDS (p < .05). Risk factors for upper back discomfort includes age and seniority in the current unit (p < .05). Risk factors for lower back discomfort including seniority in the current unit, department type, and number of days worked per week (p < .05). CONCLUSIONS: The results of this study can serve as a reference for nursing administration managers and decision-makers for reducing musculoskeletal discomfort among nurses and thereby achieving superior quality in clinical care.


Assuntos
Doenças Musculoesqueléticas/epidemiologia , Recursos Humanos de Enfermagem no Hospital , Doenças Profissionais/epidemiologia , Adulto , Dor nas Costas/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cervicalgia/epidemiologia , Prevalência , Fatores de Risco , Inquéritos e Questionários
13.
JAMA Netw Open ; 3(4): e202012, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-32239222

RESUMO

Importance: Prior studies have identified an association between obesity and prescription opioid use in the US. However, the pain conditions that are factors in this association remain unestablished. Objective: To investigate the association between obesity and pain diagnoses recorded by primary care clinicians as reasons for prescription of opioids. Design, Setting, and Participants: A cross-sectional study including 565 930 patients aged 35 to 64 years with a body mass index (BMI) measurement recorded in 2016 was conducted. Electronic health records of patients seen by primary care clinicians in the US in the multipayer athenahealth network from January 1, 2015, to December 31, 2017, were reviewed, and data were analyzed from March 1 to September 15, 2019. Main Outcomes and Measures: Any prescription of opioids in the 365 days before or after the first BMI measurement in 2016 were identified. All International Classification of Diseases, Ninth Revision, and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, claims within 7 days before each opioid prescription were captured and classified using a pain diagnosis typologic system. Weight was categorized as underweight (BMI, 18.5-19.9), normal weight (BMI, 20.0-24.9), overweight (BMI, 25.0-29.9), obese I (BMI, 30-34.9), obese II (BMI, 35.0-39.9), obese III (BMI, 40.0-49.9), and obese IV (BMI, 50.0-80.0). Results: Among 565 930 patients, 329 083 (58.1%) were women. A total of 125 093 patients (22.1%) were aged 35 to 44 years, 199 384 patients (35.2%) were 45 to 54 years, and 241 453 patients (42.7%) were 55 to 64 years. A total of 177 631 patients (31.4%) were overweight and 273 135 patients (48.2%) were obese at baseline. Over 2 years, 93 954 patients (16.6%) were prescribed opioids. The risk of receiving prescription opioids increased progressively with BMI (adjusted relative risk for overweight: 1.08; 95% CI, 1.06-1.10; obese I: 1.24; 95% CI, 1.22-1.26; obese II: 1.33; 95% CI, 1.30-1.36; obese III: 1.48; 95% CI, 1.45-1.51; and obese IV, 1.71; 95% CI, 1.65-1.77). The percentage of patients with opioid prescriptions attributable to an overweight or obese BMI was 16.2% (95% CI, 15.0%-17.4%). Prescription opioids for management of osteoarthritis (relative risk for obese vs normal weight, 1.90; 95% CI, 1.77-2.05) and other joint disorders (relative risk, 1.63; 95% CI, 1.55-1.72) both had stronger associations with obesity than the mean for any pain diagnosis (relative risk, 1.33; 95% CI, 1.31-1.36). Osteoarthritis, other joint disorders, and other back disorders comprised a combined 53.4% of the absolute difference in prescription of opioids by obesity. Conclusions and Relevance: Joint and back disorders appear to be the most important diagnoses in explaining the increased receipt of opioid prescriptions among patients with obesity. Addressing the opioid crisis will require attention to underlying sources of demand for prescription opioids, including obesity, through its associations with pain.


Assuntos
Analgésicos Opioides/efeitos adversos , Obesidade/complicações , Dor/tratamento farmacológico , Prescrições/estatística & dados numéricos , Adulto , Analgésicos Opioides/uso terapêutico , Dor nas Costas/tratamento farmacológico , Dor nas Costas/epidemiologia , Índice de Massa Corporal , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Artropatias/tratamento farmacológico , Artropatias/epidemiologia , Masculino , Pessoa de Meia-Idade , Obesidade/classificação , Obesidade/epidemiologia , Osteoartrite/tratamento farmacológico , Osteoartrite/epidemiologia , Dor/etiologia , Atenção Primária à Saúde/normas , Risco , Estados Unidos/epidemiologia
14.
World Neurosurg ; 139: e474-e479, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32311559

RESUMO

OBJECTIVE: Sexual function is an important factor contributing to quality of life. Adult spinal deformity (ASD) patients may have sexual limitations due to lumbar spinal stiffness that may be affected by long-segment fusion. METHODS: This study utilized a multicenter, prospectively defined, consecutive cohort of ASD patients. The primary outcome in this study was the Lumbar Stiffness Disability Index (LSDI) question 10: "Choose the statement that best describes the effect of low back stiffness on your ability to engage in sexual intercourse". RESULTS: In total, 368 patients were included in this study, including 76 men and 292 women, of which 80.7% (n = 293) underwent 9 or more level fusion and 74.4% (n = 270) had pelvic fixation. Baseline LSDI sexual function scores averaged 1.7 (SD 1.3), which improved to 1.3 (SD 1.2) at 2-year follow-up (P = 0.0008). After adjusting for confounding factors, worse LSDI sexual function score was strongly associated with worse Oswestry Disability Index, Scoliosis Research Society-22r total, and SF-36 Physical Component Summary and Mental Component Summary scores at both baseline and 2-year follow-up (p<0.05 for all comparisons). Predictors of poorer baseline sexual function included older age, increased SVA, and increased back pain (p<0.05 for all comparisons). Predictors of improvement in sexual function at 2-year follow-up included sagittal vertical axis improvement (P = 0.0032) and decreased postoperative back pain (P < 0.0001). CONCLUSIONS: This study found that sexual dysfunction scores due to lumbar stiffness significantly improved after surgery for ASD. Additionally, lumbar stiffness-related sexual dysfunction is strongly related to overall outcome measured by Oswestry Disability Index and Scoliosis Research Society-22r total score, highlighting the importance of sexual health on overall outcome in ASD patients.


Assuntos
Região Lombossacral , Complicações Pós-Operatórias/epidemiologia , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Fisiológicas/etiologia , Doenças da Coluna Vertebral/complicações , Doenças da Coluna Vertebral/etiologia , Fusão Vertebral/métodos , Coluna Vertebral/anormalidades , Coluna Vertebral/cirurgia , Adulto , Idoso , Dor nas Costas/epidemiologia , Dor nas Costas/etiologia , Estudos de Coortes , Coito , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Escoliose/cirurgia , Resultado do Tratamento
15.
Pain Res Manag ; 2020: 9874739, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32184913

RESUMO

Objectives: Acute pain trajectories are associated with long-term outcomes such as persistent pain and functional disability in adults. However, there are limited data on acute postoperative pain trajectories in the pediatric population. The aims of this study were to investigate acute postoperative pain trajectories, their predictors, and their impact on long- term outcomes in adolescents with idiopathic scoliosis. Methods: We evaluated the preoperative pain intensity, use of analgesics, psychosocial measures and physical functioning of adolescents scheduled to undergo spinal fusion, and their average 6-hour self-reported pain intensity scores for their entire hospital stay. Six months after surgery, baseline variables were reassessed. We used growth mixture modeling to conduct acute postoperative pain trajectory analysis and to identify predictors of pain trajectories. Generalized linear models were conducted to determine whether acute pain trajectories predict long-term outcomes. Results: One hundred and six patients were included in the best-fitted acute pain trajectory model that included four classes that differed in initial pain intensity and rates of change over time. Preoperative pain catastrophizer status and use of analgesics significantly predicted pain trajectory membership. Furthermore, at the 6-month follow-up, patients experiencing moderate-to-severe pain in the acute postoperative period were more likely to report higher levels of pain severity, use pain medication, and miss a greater number of school/work days due to back pain in the last three months. Discussion. Preoperative assessment and analyzing the progression of pain in the acute postoperative period can help identify those at risk of negative long-term outcomes after surgery.


Assuntos
Dor Pós-Operatória , Escoliose/complicações , Escoliose/cirurgia , Fusão Vertebral/efeitos adversos , Dor Aguda/epidemiologia , Dor Aguda/etiologia , Adolescente , Dor nas Costas/epidemiologia , Dor nas Costas/etiologia , Criança , Dor Crônica/epidemiologia , Feminino , Humanos , Masculino , Medição da Dor , Dor Pós-Operatória/epidemiologia , Autorrelato
16.
Cien Saude Colet ; 25(3): 1041-1049, 2020 Mar.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32159672

RESUMO

Chronic Back Problem (CBP) is a public health concern. In Brazil, data from the National Health Survey (PNS) estimated 27.0 million people (18.5%) who reported CBP, affecting more women than men. This study aims to identify the factors associated with CBP among women of childbearing age. It is a cross-sectional study carried out with data from the PNS, where the dependent variable was the prevalence of CBP, and associated factors included socio-demographic items, life habits, reproductive history, nutritional status, diagnosis of depression and health perception. A total of 22,621 women aged 18 to 49 years were interviewed. Of these, 14.8% reported having CBP. The risk factors studied were: increased age; living with spouse; multiparity; smoking; overweight or obese, having Waist Circumference (WC) above 80cm and Circumference/Height (C/E) index above 0.5; negative self-perception of health; and depression. The only protective factor associated with CBP risk reduction was education level. We conclude that age, living with a spouse/partner, smoking, multiparity, being overweight or obese, increased risk for cardiovascular diseases, depression and negative self-perceived health are associated with the development of CBP in women of childbearing age.


Assuntos
Dor nas Costas/epidemiologia , Dor Crônica/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Adulto Jovem
17.
Artigo em Alemão | MEDLINE | ID: mdl-32189044

RESUMO

BACKGROUND: Musculoskeletal diseases and symptoms are very common in the general population. They lead to high healthcare costs and pose a significant burden to the national economy. OBJECTIVES: Based on data from the population-based German National Cohort (GNC), frequencies of musculoskeletal symptoms and diseases are reported, including back pain, osteoporosis, osteoarthritis, and arthritis. MATERIALS AND METHODS: Data were collected from March 2014 to March 2017 in adults aged 20-75 years during the first half of the baseline survey of the GNC. The sample comprised 101,779 interviewed subjects, including 9370 subjects who underwent clinical musculoskeletal examinations. The interview included questions about specific musculoskeletal disorders. A clinical examination of the hand provided information about palpable swollen joints and pressure-sensitive joints. Resting pain of the knees and hips was also assessed by a clinical examination. Frequencies were standardized to the German standard population of the year 2011. RESULTS: Having ever been diagnosed with recurrent back pain (22.5%) or osteoarthritis (20.6%) were the most common complaints reported in the interview; osteoporosis (2.9%) and rheumatoid arthritis (1.9%) were stated more seldom. According to the hand examination, 6.0% of all participants experienced pain in at least one finger joint. Resting pain was present in at least one knee among 8.2% and in at least one hip among 5.1% of the participants as assessed during the clinical examination. Women were more likely to report musculoskeletal disorders and symptoms than men. The proportion of adults affected by musculoskeletal diseases increased strongly with age. CONCLUSION: Musculoskeletal disorders and symptoms occur frequently. The burden of complaints and diagnoses is comparable to previous population-based surveys.


Assuntos
Doenças Musculoesqueléticas/epidemiologia , Adulto , Idoso , Dor nas Costas/epidemiologia , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite/epidemiologia , Prevalência , Inquéritos e Questionários , Adulto Jovem
18.
Fertil Steril ; 113(3): 627-635.e1, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32192595

RESUMO

OBJECTIVE: To evaluate the efficacy and safety of dienogest (DNG), a progestational 19-norsteroid, in patients with primary and secondary dysmenorrhea. DESIGN: Phase III, randomized, double-blind, multicenter, placebo-controlled study. SETTING: Clinical study sites in Japan. PATIENT(S): Ninety-four women with dysmenorrhea. INTERVENTION(S): Random assignment to receive DNG (1 mg/day, orally) or placebo for 12 weeks; patients treated for anemia before randomization in cases of complicated anemia. MAIN OUTCOME MEASURE(S): Change in the dysmenorrhea score from baseline to week 12 of treatment with visual analog scale used for pain assessment. RESULT(S): The DNG group was superior to the placebo group in terms of the change from baseline in the dysmenorrhea score at week 12 of treatment in patients with dysmenorrhea. In both primary and secondary dysmenorrhea, the DNG group was superior to the placebo group for each diagnostic category. The mean serum estradiol concentrations were similar between the DNG and the placebo groups. Although the incidence of irregular uterine bleeding was higher in the DNG group, there were no severe or serious events. Most events of genital bleeding were spotting or breakthrough bleeding, suggesting DNG was well tolerated. CONCLUSION(S): In both primary and secondary dysmenorrhea, DNG at 1 mg/day relieved pain and was well tolerated. CLINICAL TRIAL REGISTRATION NUMBER: JapicCTI-173547(en).


Assuntos
Dismenorreia/tratamento farmacológico , Nandrolona/análogos & derivados , Administração Oral , Adulto , Dor nas Costas/tratamento farmacológico , Dor nas Costas/epidemiologia , Dor nas Costas/etiologia , Formas de Dosagem , Método Duplo-Cego , Dismenorreia/complicações , Dismenorreia/epidemiologia , Feminino , Humanos , Japão/epidemiologia , Nandrolona/administração & dosagem , Nandrolona/efeitos adversos , Medição da Dor , Dor Pélvica/tratamento farmacológico , Dor Pélvica/epidemiologia , Dor Pélvica/etiologia , Placebos , Resultado do Tratamento , Adulto Jovem
19.
Am J Obstet Gynecol ; 223(4): 566.e1-566.e13, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32217114

RESUMO

OBJECTIVE: To evaluate the association between opioid prescribing during pregnancy and new persistent opioid use in the year following delivery. MATERIALS AND METHODS: This nationwide retrospective cohort study included patients aged 12-55 years in Optum's deidentified Clinformatics Data Mart Database who were undergoing vaginal delivery or cesarean delivery from 2008 to 2016, with continuous enrollment from 2 years before birth to 1 year postdischarge. Women were included if they were opioid naive in pregnancy (ie, did not fill an opioid prescription 2 years to 9 months before delivery) and did not undergo a procedure within the year after discharge. The exposure was filling an opioid prescription in pregnancy. The primary outcome was new persistent opioid use, defined as a pharmacy claim for ≥1 opioid prescription between 4 and 90 days postdischarge and ≥1 prescription between 91 and 365 days postdischarge. Clinical and demographic covariates were included. Analyses included descriptive statistics and multivariable logistic regression, adjusting for clinical and demographic covariates. RESULTS: Of 158,425 childbirths identified, 101,013 (63.8%) were by vaginal delivery and 57,412 (36.2%) cesarean delivery. Among all patients, 6.0% (9429) filled an opioid prescription during pregnancy. The factors associated with filling an opioid in pregnancy were having a nondelivery procedure in pregnancy (adjusted odds ratio, 9.60; 95% confidence interval, 8.81-10.47) and having an emergency room visit during pregnancy (adjusted odds ratio, 2.48; 95% confidence interval, 2.37-2.59). Of women who received an opioid in pregnancy, 4% (379) developed new persistent opioid use. The factors most associated with new persistent opioid use were receiving an opioid prescription during pregnancy (adjusted odds ratio, 3.45; 95% confidence interval, 3.04-3.92) and filling a peripartum opioid prescription (1 week prior to 3 days postdischarge) adjusted odds ratio, 2.28, 95% confidence interval (2.02-2.57). Though having a procedure during pregnancy was associated with increased receipt of an opioid prescription, it was also associated with reduced new persistent opioid use (adjusted odds ratio, 0.72; 95% confidence interval, 0.52-0.99). CONCLUSION: Women who receive an opioid prescription during pregnancy are more likely to experience new persistent opioid use. Maternity care providers must balance pain management in pregnancy with potential risks of opioids.


Assuntos
Analgésicos Opioides/uso terapêutico , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Dor/tratamento farmacológico , Complicações na Gravidez/tratamento farmacológico , Dor Abdominal/tratamento farmacológico , Dor Abdominal/epidemiologia , Adulto , Dor nas Costas/tratamento farmacológico , Dor nas Costas/epidemiologia , Cesárea , Estudos de Coortes , Parto Obstétrico , Serviço Hospitalar de Emergência/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Renda/estatística & dados numéricos , Modelos Logísticos , Transtornos Mentais/epidemiologia , Período Periparto , Gravidez , Estudos Retrospectivos , Fatores de Risco , Infecções Urinárias/epidemiologia , Adulto Jovem
20.
Ann Agric Environ Med ; 27(1): 36-42, 2020 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-32208577

RESUMO

INTRODUCTION AND OBJECTIVE: Back pain affects specific occupational groups, among which healthcare workers are the most predisposed. Therefore, the aim of this study was to determine the interdependences between subjective disability and their correlation with pain intensity and quality of life assessment among professionally active medical workers, taking into account working, socio-demographic and health conditions. MATERIAL AND METHODS: The cross-sectional study enrolled 110 professionally active medical workers (nurses, midwives, paramedics and physiotherapists). The study was conducted by a diagnostic survey method using 4 questionnaires: Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), World Health Organization Quality of Life BREF (WHOQoL-BREF), and the authors' questionnaire. RESULTS: Back pain was reported by 103 respondents (94%) with the lumbar area indicated the most frequently (72.81%). Severe pain every day was reported by 49.51% of respondents and was associated with longer working time. ODI questionnaire confirmed III and IV degrees of disability in paramedics and nurses, who additionally obtained the lowest results in the quality of life assessment. Correlations between age and VAS were demonstrated (p=0.002), and between VAS and ODI pain (p<0.0001) and ODI disability (p<0.0001). CONCLUSIONS: Back pain associated with professional activities is the consequence of overload. Health care workers should be included in a preventive programme and attend systematic ergonomics courses. Health care facilities should be retrofitted with equipment enabling work in accordance with the principles of ergonomics. The ODI questionnaire, together with the VAS method and scales for testing the quality of life, are useful tools in the clinical assessment of individuals with back pain.


Assuntos
Dor nas Costas/epidemiologia , Pessoal de Saúde , Doenças Profissionais/epidemiologia , Qualidade de Vida , Adulto , Fatores Etários , Pessoal Técnico de Saúde , Estudos Transversais , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tocologia , Enfermeiras e Enfermeiros , Fisioterapeutas , Polônia/epidemiologia , Inquéritos e Questionários , Carga de Trabalho
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