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1.
Medicine (Baltimore) ; 99(40): e22538, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019462

RESUMO

The current studies revealed inconsistent relationship between reproductive factors and osteoarthritis. Community-based research has not been conducted in China. The study was to examine the association of reproductive factors with the prevalence of knee osteoarthritis (OA).Through a multistage stratified random sampling method, 10 streets or villages from 5 cities in Hunan province were randomly selected, a total 2746 eligible women aged 50 to 83 were recruited in this cross-sectional study. A structured questionnaire including demographic factors, socio-economic status, reproductive factors, and knee OA was used. According to the criteria of American College of Rheumatology, clinical knee OA was assessed by doctors in community or village health clinics for knee pain, age, morning stiffness, crepitus on active motion or for knee pain, morning stiffness, crepitus on active motion, and tenderness of the bony navigation of the joint. Self-reported age of menarche, parity, abortion history, and menopausal status were collected.The prevalence of knee OA was 13.44%. Abortion is associated with knee OA (odds ratio [OR] = 1.271, 95% confidence interval [CI] = 1.007, 1.606), but age at menarche, parity, and menopausal status were not the factors. Furthermore, age (OR = 1.040, 95% CI = 1.020, 1.060), weight (OR = 1.019, 95% CI = 1.004, 1.035), higher education level (OR = 1.530, 95% CI = 1.121, 2.088), higher monthly household income (OR = .583, 95% CI = 0.441, 0.770 for 3000-4999 ¥ and OR = 0.599, 95% CI = 0.431, 0.833 for 5000 ¥ or more), and chronic gastritis (OR = 3.364, 95% CI = 2.548, 4.442) were associated with knee OA.Abortion may increase the risk of knee OA. Special attention should be paid to women with a history of abortion, and women who are planning to abort should be informed of the risk of knee OA later in life. The relationship between abortion and knee OA should be interpreted with caution and further confirmed.


Assuntos
Aborto Espontâneo/epidemiologia , Osteoartrite do Joelho/epidemiologia , Osteoartrite do Joelho/etiologia , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/patologia , Dor/diagnóstico , Dor/epidemiologia , Prevalência , Radiografia/métodos , Medição de Risco , Autorrelato , Classe Social , Inquéritos e Questionários
4.
Psychiatr Danub ; 32(Suppl 2): 290-297, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32970649

RESUMO

INTRODUCTION: Sensitive skin has been described as a syndrome defined by the occurrence of unpleasant sensations (stinging, burning, pain, pruritus, and tingling sensations) in response to stimuli that normally should not provoke such sensations. Although often transient, and in many cases unaccompanied by visual dermatological responses, sensitive skin affects the quality of life. The aim of this survey was to assess the prevalence of sensitive skin and collect clinical data on sensitive skin in the population of Herzegovina-Neretva County. SUBJECTS AND METHODS: The survey included a total of 73 participants, 45 female and 28 male, aged 20 years and above, with a diagnosis of sensitive skin syndrome (SSS) confirmed by physicians. A dermatological exam assessing skin type, phototype and skin sensitivity was performed. The survey collected an assortment of information including demographics and included customized standardized questionnaires that closely examine skin sensitivity and the burden of sensitive skin. RESULTS: Findings concurred with existing evidence that individuals with sensitive skin represent almost half the examined population. The prevalence of perceived sensitive skin was significantly higher in females than in males. The main skin symptom was itching, followed by prickling, warmth and numbness. Our results clearly show that there is a burden of sensitive skin. CONCLUSION: This study investigated the prevalence of sensitive skin and the burden of sensitive skin in the population of Herzegovina-Neretva County. It is the first to focus on sensitive skin among Herzegovina-Neretva County population. Further studies are needed to bolster epidemiological data and physiological pathways of sensitive skin syndrome.


Assuntos
Dermatopatias/epidemiologia , Adulto , Bósnia e Herzegóvina/epidemiologia , Feminino , Humanos , Masculino , Dor/epidemiologia , Prevalência , Prurido/epidemiologia , Qualidade de Vida , Síndrome , Adulto Jovem
5.
Orv Hetil ; 161(33): 1373-1381, 2020 08.
Artigo em Húngaro | MEDLINE | ID: mdl-32749234

RESUMO

INTRODUCTION: Osteoarthritis (OA) as the most common joint disease is a major public health concern. AIM: To investigate the effect of multimorbidity on functional and quality of life outcomes in women with generalized osteoathritis (hand and knee arthritis, GOA). METHOD: In this cross-sectional study, patients according to the American College of Rheumatology (ACR) criteria for OA were invited. The control group consisted of subjects without any musculoskeletal symptoms, osteoarthritis or inflammatory rheumatic disease. Comorbidity count was calculated from the investigated comorbidities. In the GOA group, the function was assessed by Western Ontario and McMaster Universities Arthritis Index (WOMAC), Cochin Hand Scale, Knee Injury and Osteoarthritis Outcome Score (KOOS), Health Assessment Questionnaire (HAQ), while quality of life was measured in both groups with the EuroQol-5D Scale. Interaction between summarized comorbidity count, age, body mass index (BMI) and scores were analysed. Descriptive statistics, two-sample t-test and Pearson's correlation test were used for data analysis. RESULTS: The study groups included 200-200 participants with a similar age spread. Significant correlation was demonstrated in both study groups between higher comorbidity count and older age (0.37, p<0.001, and 0.24, p<0.001 in the GOA and the control group, respectively) and higher BMI (0.18, p: 0.01, and 0.45, p<0.001 in the GOA and the control group, respectively). In GOA, the increasing comorbidity number had a negative effect on the measured outcomes. CONCLUSIONS: Age and BMI showed strong correlation with multimorbidity in both groups. The lower correlation between BMI and comorbidity count in the GOA group requires further investigation and may suggest different interactions. Orv Hetil. 2020; 161(32): 1332-1340.


Assuntos
Atividades Cotidianas , Osteoartrite do Joelho/psicologia , Qualidade de Vida , Fatores Etários , Idoso , Índice de Massa Corporal , Estudos de Casos e Controles , Comorbidade , Estudos Transversais , Feminino , Humanos , Multimorbidade , Dor/epidemiologia
7.
PLoS One ; 15(7): e0236390, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32702007

RESUMO

BACKGROUND: Nurses have a primary role in providing palliative and end-of-life (EOL) care. Their knowledge of EOL care, attitudes toward care of the dying, and palliative care self-efficacy are important in care delivery. Little is known regarding palliative care preparedness among Mongolian nurses. This study examines palliative care knowledge, attitude towards death and dying, and self-efficacy among Mongolian nurses, and examines predictors of self-efficacy. METHODS: A cross-sectional descriptive study was conducted. Participants were 141 nurses employed at the National Cancer Center in Mongolia. Data was collected using a self-administered questionnaire. RESULTS: The median score for the knowledge of palliative care was 8.0/20. "Psychosocial and spiritual care" was the lowest score on the palliative care knowledge subscale. The mean score for attitude toward care of the dying was 69.1%, indicating positive attitudes. The mean score for the palliative care self-efficacy was 33.8/48. Nurses reported low self-efficacy toward communicating with dying patients and their families, and managing delirium. Palliative care knowledge and duration of experience as an oncology nurse significantly predicted self-efficacy toward palliative care, accounting for 14.0% of the variance. CONCLUSIONS: Palliative education for nurses should address the knowledge gaps in EOL care and focus in increasing palliative care self-efficacy. Considering palliative care knowledge and nursing experience as an oncology nurse were significant predictors of self-efficacy toward palliative care, more effort is needed to fill the knowledge gaps in EOL care among nurses, especially for less experienced nurses.


Assuntos
Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Enfermeiras e Enfermeiros/normas , Cuidados Paliativos/normas , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Oncologia/tendências , Pessoa de Meia-Idade , Mongólia/epidemiologia , Dor/epidemiologia , Dor/patologia , Pacientes , Autoeficácia , Inquéritos e Questionários , Assistência Terminal
8.
PLoS One ; 15(7): e0235346, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32667951

RESUMO

Several studies have recently suggested that an abnormal processing of respiratory interoceptive and nociceptive (painful) stimuli may contribute to eating disorder (ED) pathophysiology. Mood and anxiety disorders (MA) are also characterized by abnormal respiratory symptoms, and show substantial comorbidity with ED. However, no studies have examined both respiratory and pain processing simultaneously within ED and MA. The present study systematically evaluated responses to perturbations of respiratory and nociceptive signals across the levels of physiology, behavior, and symptom report in a transdiagnostic ED sample (n = 51) that was individually matched to MA individuals (n = 51) and healthy comparisons (HC; n = 51). Participants underwent an inspiratory breath-holding challenge as a probe of respiratory interoception and a cold pressor challenge as a probe of pain processing. We expected both clinical groups to report greater stress and fear in response to respiratory and nociceptive perturbation than HCs, in the absence of differential physiological and behavioral responses. During breath-holding, both the ED and MA groups reported significantly more stress, feelings of suffocation, and suffocation fear than HC, with the ED group reporting the most severe symptoms. Moreover, anxiety sensitivity was related to suffocation fear only in the ED group. The heightened affective responses in the current study occurred in the absence of group differences in behavioral (breath hold duration, cold pressor duration) and physiological (end-tidal carbon dioxide, end-tidal oxygen, heart rate, skin conductance) responses. Against our expectations, there were no group differences in the response to cold pain stimulation. A matched-subgroup analysis focusing on individuals with anorexia nervosa (n = 30) produced similar results. These findings underscore the presence of abnormal respiratory interoception in MA and suggest that hyperreactivity to respiratory signals may be a potentially overlooked clinical feature of ED.


Assuntos
Anorexia Nervosa/fisiopatologia , Transtornos de Ansiedade/fisiopatologia , Transtornos da Alimentação e da Ingestão de Alimentos/fisiopatologia , Dor Nociceptiva/fisiopatologia , Adolescente , Adulto , Afeto/fisiologia , Anorexia Nervosa/complicações , Anorexia Nervosa/epidemiologia , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/epidemiologia , Asfixia/fisiopatologia , Asfixia/terapia , Comorbidade , Medo/fisiologia , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Feminino , Humanos , Masculino , Transtornos do Humor/complicações , Transtornos do Humor/epidemiologia , Transtornos do Humor/fisiopatologia , Dor Nociceptiva/complicações , Dor Nociceptiva/epidemiologia , Dor/complicações , Dor/epidemiologia , Dor/fisiopatologia , Sistema Respiratório/fisiopatologia
9.
Clin Interv Aging ; 15: 1003-1012, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32617001

RESUMO

Purpose: To assess comorbidity burden and pain-management patterns among working-aged patients with knee osteoarthritis only (KOA/O) and patients with knee osteoarthritis plus osteoarthritis at another site (KOA/+) in Japan. Patients and Methods: Retrospective claims data analysis was conducted using the Japan Medical Data Center database. Working-aged adults (aged 40 to 71 years) with 5 years of follow-up and diagnosed with knee osteoarthritis (KOA) between January 1, 2011, and December 31, 2012, were evaluated. The first claim with a KOA diagnosis defined the index date. Patients were divided into two mutually exclusive cohorts: KOA/O and KOA/+. Longitudinal pain-management patterns during each year of follow-up were analyzed. Results: A total of 2542 patients met study criteria: 1575 KOA/O and 967 KOA/+. Mean age and number of comorbidities were higher among the KOA/+ versus KOA/O cohort. Pharmaceutical treatment was received by 91.5% of patients in the KOA/+ compared with 85.1% of patients in the KOA/O cohort during the first year of follow-up. The most common pharmacological treatment received during the first year of follow-up was either topical or oral nonsteroidal anti-inflammatory drugs for both cohorts. During each year of follow-up, the KOA/+ cohort had greater proportion of patients with at least one health-care encounter (ie, hospital admissions, outpatient and pharmacy visits) and higher direct medical costs compared with the KOA/O cohort. Conclusion: This study demonstrates that a greater proportion of the working population with KOA/+ received pain-related treatment compared with patients with KOA/O. Further studies are necessary to evaluate appropriate pain management for both KOA only and KOA with other sites.


Assuntos
Osteoartrite do Joelho/terapia , Manejo da Dor/estatística & dados numéricos , Dor/prevenção & controle , Idoso , Estudos de Coortes , Comorbidade , Emprego/estatística & dados numéricos , Feminino , Humanos , Japão , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Dor/epidemiologia , Medição da Dor/estatística & dados numéricos , Estudos Retrospectivos
10.
Niger J Clin Pract ; 23(6): 775-782, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32525111

RESUMO

Objective: The aim of this study was to investigate the relationship between anxiety level and quality of life in patients with diabetes mellitus and the sociodemographic factors affecting them. Materials and Methods: This cross-sectional study enrolled 150 patients with DM who presented to the endocrinology clinic of Gaziantep University Sahinbey Research and Training Hospital for outpatient treatment between March 2017 and April 2017. The Beck Anxiety Inventory (BAI) and Eortc-Qlqc30 Quality of Life Scale (EORTC- QLQ-C30) were used to evaluate anxiety levels and quality of life of the patients. Results: The mean score of the patients obtained from BAI was 18 ± 13 and 51.4 ± 26 from EORTC- QLQ-C30. Mean body mass index of patients' was 27.03. There was a statistically significant negative correlation between BAI and EORTC QLQ-C30 (r:-0.359) and sub scales in terms of physical function (r: -0.253), emotional function (r: -0.201), role function (r: -0.308), cognitive function (r: -0.309) (P < 0.05). There was a statistically significant positive correlation between BAI and the symptom subscales of EORTC QLQ-C30 in terms of pain score (r: 0.276), fatigue score (r: 0.305), dyspnea score (r: 0.198), insomnia score (r: 0.247), loss of appetite score (r: 0.216) (P < 0.05). Conclusion: A negative relationship was determined between anxiety levels and quality of life. Age, marital status, number of spouses, co inhabitants at home, educational status, living place were related with both quality of life and anxiety levels of DM patients. Increasing the psychosocial support systems of individuals with DM may reduce their anxiety levels and increase quality of life.


Assuntos
Depressão/etiologia , Diabetes Mellitus Tipo 2/psicologia , Qualidade de Vida/psicologia , Adolescente , Adulto , Idoso , Ansiedade/epidemiologia , Ansiedade/etiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Dispneia/epidemiologia , Fadiga/epidemiologia , Fadiga/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/epidemiologia , Escalas de Graduação Psiquiátrica , Características de Residência , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Cônjuges , Inquéritos e Questionários , Turquia/epidemiologia , Adulto Jovem
11.
BMC Public Health ; 20(1): 988, 2020 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-32576168

RESUMO

BACKGROUND: Patients´ own perceptions and evaluations of symptoms, functioning and other health-related factors, i.e. Patient Reported Outcomes (PROs), are important elements for providing good patient care. Symptoms are subjective and best elicited by the patient orally or by using PRO measures (PROMs), be it on paper, or as electronic assessment tools. Reference values on frequently used PROMs facilitate the interpretation of scores for use in clinics and research settings, by comparing patient data with relevant samples from the general population. Study objectives were to (1) present reference values for the M.D. Anderson Symptom Inventory (MDASI) (2) examine the occurrence and intensity of symptoms assessed by the MDASI in a general Norwegian adult population sample, and (3) examine factors associated with higher symptom burden defined as the sum score of all symptoms, and factors associated with symptoms` interference on functions. METHODS: In 2015, MDASI was sent by mail as part of a larger survey, to a representative sample of the general Norwegian adult population (N = 6165). Medical comorbidities were assessed by the Self-Administered Comorbidity Questionnaire. Depression was self-reported on the Patient Health Questionnaire 9 (PHQ-9). Linear multivariable regression analysis was used to examine for factors associated with MDASI sum score and factors associated with symptoms' interference on functions. RESULTS: The response rate was 36%. More women (54%) than men (46%) responded. Mean age was 55 years (SD 14). The most frequent symptoms were fatigue (59.7%), drowsiness (56.2%) and pain (56.1%). Fatigue, pain and disturbed sleep had the highest mean scores. The presence of one or more comorbidities, increasing PHQ-9 score and lower level of education were associated with higher MDASI sum score (p < 0.001). The MDASI sum score and the PHQ-9 score were positively associated with all interference items (p < 0.001) except for walking (p = 0.22). CONCLUSION: This study provides the first Norwegian reference values for MDASI. The presence of one or more comorbidities, higher level of depressive symptoms and lower level of education were significantly associated with higher MDASI sum score. These covariates must be controlled for when using the reference values.


Assuntos
Autoavaliação Diagnóstica , Fadiga/epidemiologia , Dor/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Avaliação de Sintomas/estatística & dados numéricos , Adulto , Idoso , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Questionário de Saúde do Paciente , Medidas de Resultados Relatados pelo Paciente , Prevalência , Valores de Referência , Inquéritos e Questionários
12.
Br J Sports Med ; 54(21): 1288-1293, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32586943

RESUMO

AIM: To report the epidemiology of injury and illness in elite rowers over eight seasons (two Olympiads). METHODS: All athletes selected to the Australian Rowing Team between 2009 and 2016 were monitored prospectively under surveillance for injury and illness. The incidence and burden of injury and illness were calculated per 1000 athlete days (ADs). The body area, mechanism and type of all injuries were recorded and followed until the resumption of full training. We used interrupted time series analyses to examine the association between fixed and dynamic ergometer testing on rowers' injury rates. Time lost from illness was also recorded. RESULTS: All 153 rowers selected over eight seasons were observed for 48 611 AD. 270 injuries occurred with an incidence of 4.1-6.4 injuries per 1000 AD. Training days lost totalled 4522 (9.2% AD). The most frequent area injured was the lumbar region (84 cases, 1.7% AD) but the greatest burden was from chest wall injuries (64 cases, 2.6% AD.) Overuse injuries (n=224, 83%) were more frequent than acute injuries (n=42, 15%). The most common activity at the time of injury was on-water rowing training (n=191, 68). Female rowers were at 1.4 times the relative risk of chest wall injuries than male rowers; they had half the relative risk of lumbar injuries of male rowers. The implementation of a dynamic ergometers testing policy (Concept II on sliders) was positively associated with a lower incidence and burden of low back injury compared with fixed ergometers (Concept II). Illness accounted for the greatest number of case presentations (128, 32.2% cases, 1.2% AD). CONCLUSIONS: Chest wall and lumbar injuries caused training time loss. Policy decisions regarding ergometer testing modality were associated with lumbar injury rates. As in many sports, illness burden has been under-recognised in elite Australian rowers.


Assuntos
Traumatismos em Atletas/epidemiologia , Esportes Aquáticos/lesões , Austrália/epidemiologia , Transtornos Traumáticos Cumulativos/epidemiologia , Teste de Esforço , Feminino , Traumatismos do Antebraço/epidemiologia , Humanos , Incidência , Traumatismos do Joelho/epidemiologia , Estudos Longitudinais , Dor Lombar/epidemiologia , Região Lombossacral/lesões , Masculino , Dor/epidemiologia , Estudos Prospectivos , Fatores de Risco , Fatores Sexuais , Parede Torácica/lesões
13.
Ann Hematol ; 99(6): 1217-1223, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32367178

RESUMO

While fluid replacement therapy is a primary treatment modality used in vaso-occlusive crises for sickle cell disease, data is limited on its safety, efficacy, and variability. We performed a retrospective analysis on 157 unique patient encounters from 49 sickle cell patients hospitalized with a vaso-occlusive episode at our institution from 2013 to 2017. The median length of hospital stay was 4 days (IQR 2-7). The mean total amount of intravenous fluid administered during the hospitalization was 7.4 L (Std 9.6). The mean total amount of fluid intake including intravenous fluids, blood transfusions, and oral fluids was 14.2 L (Std 18.2). Multivariate analyses revealed significant associations between the development of any adverse event (including a new oxygen requirement, acute chest syndrome, aspiration event, other hospital-acquired infection, acute kidney injury, and intensive care unit transfer) and the following variables: intravenous fluid administered in the first 24 h (p = 0.001, OR 1.899, 95% CI 1.319-2.733), total amount of intravenous fluid administered (p = 0.005, OR 1.081, 95% CI 1.023-1.141), and total amount of fluid intake including oral fluids, blood transfusions, and intravenous fluids (p = 0.009, OR 1.046, 95% CI 1.011-1.081). Other factors found to be significantly associated with any adverse event were dialysis dependence prior to admission (p < 0.001, OR 12.984, 95% CI 3.660-46.056) and admission to an inpatient service versus an emergency room or observation unit (p = 0.008, OR 3.201, 95% CI 1.346-7.612). While fluid administration may theoretically slow the sickling process, this data suggests that fluid administration during a vaso-occlusive episode, and especially total volume given in the first 24 h, may also lead to adverse events.


Assuntos
Anemia Falciforme/epidemiologia , Anemia Falciforme/terapia , Hidratação/tendências , Manejo da Dor/tendências , Dor/epidemiologia , Administração Intravenosa , Adulto , Anemia Falciforme/diagnóstico , Feminino , Hidratação/métodos , Hospitalização/tendências , Humanos , Masculino , Dor/diagnóstico , Manejo da Dor/métodos , Estudos Retrospectivos , Resultado do Tratamento
14.
Med Care ; 58(6): 557-565, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32412942

RESUMO

OBJECTIVE: The objective of this study was to develop the classification system for version of the SF-6D (SF-6Dv2) from the SF-36v2. SF-6Dv2 is an improved version of SF-6D, one of the most widely used generic measures of health for the calculation of quality-adjusted life years. STUDY DESIGN AND SETTING: A 3-step process was undertaken to generate a new classification system: (1) factor analysis to establish dimensionality; (2) Rasch analysis to understand item performance; and (3) tests of differential item function. To evaluate robustness, Rasch analyses were performed in multiple subsets of 2 large cross-sectional datasets from recently discharged hospital patients and online patient samples. RESULTS: On the basis of factor analysis, other psychometric evidence, cross-cultural considerations, and amenability to valuation, the 6-dimension classification used in SF-6D was maintained. SF-6Dv2 resulted in the following modifications to SF-6D: a simpler classification of physical function with clearer separation between levels; a more detailed 5-level description of role limitations; using negative wording to describe vitality; and using pain severity rather than pain interference. CONCLUSIONS: The SF-6Dv2 classification system describes more distinct levels of health than SF-6D, changes the descriptions used for a number of dimensions and provides clearer wording for health state valuation. The second stage of the study has developed a utility value set using discrete choice methods so that the measure can be used in health technology assessment. Further work should investigate the psychometric characteristics of the new instrument.


Assuntos
Análise Custo-Benefício/métodos , Nível de Saúde , Saúde Mental , Desempenho Físico Funcional , Inquéritos e Questionários/normas , Adolescente , Adulto , Idoso , Análise Custo-Benefício/normas , Estudos Transversais , Competência Cultural , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/epidemiologia , Psicometria , Anos de Vida Ajustados por Qualidade de Vida , Reprodutibilidade dos Testes , Participação Social , Fatores Socioeconômicos , Adulto Jovem
15.
J Headache Pain ; 21(1): 52, 2020 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-32404046

RESUMO

BACKGROUND: Pain is a common symptom, often associated with neurological and musculoskeletal conditions, and experienced especially by females and by older people. The aims of this study are to evaluate the temporal variations of pain rates among general populations for the period 1991-2015 and to project 10-year pain rates. METHODS: We used the harmonized dataset of ATHLOS project, which included 660,028 valid observations in the period 1990-2015 and we applied Bayesian age-period-cohort modeling to perform projections up to 2025. The harmonized Pain variable covers the content "self-reported pain experienced at the time of the interview", with a dichotomous (yes or no) modality. RESULTS: Pain rates were higher among females, older subjects, in recent periods, and among observations referred to cohorts of subjects born between the 20s and the 60s. The 10-year projections indicate a noteworthy increase in pain rates in both genders and particularly among subjects aged 66 or over, for whom a 10-20% increase in pain rate is foreseen; among females only, a 10-15% increase in pain rates is foreseen for those aged 36-50. CONCLUSIONS: Projected increase in pain rates will require specific interventions by health and welfare systems, as pain is responsible for limited quality of subjective well-being, reduced employment rates and hampered work performance. Worksite and lifestyle interventions will therefore be needed to limit the impact of projected higher pain rates.


Assuntos
Dor/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Teorema de Bayes , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Autorrelato
16.
Health Qual Life Outcomes ; 18(1): 153, 2020 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-32456683

RESUMO

BACKGROUND: The association between poverty and health has been widely assessed. However, whether the association between poverty and health-related quality of life (HRQOL) holds among different groups is unknown. This study aimed to 1) assess the association between poverty and HRQOL among rural residents in China and 2) examine whether the association holds among different populations, thereby supporting policy-making and implementation. METHODS: A multistage, stratified, random household survey was conducted with self-administered questionnaires. Matched samples were generated by the censored exact matching method to reduce selection bias between the poverty and comparison groups. We applied Tobit and ordinal logit regression models to evaluate the association between poverty and HRQOL measured by the EQ-5D-3 L among different groups. RESULTS: The health utility score of the poverty group was 6.1% lower than that of comparison group (95% CI = - 0.085, - 0.037), with anxiety/depression being most common (95% CI = 1.220, 1.791). The association between poverty and HRQOL was significantly stronger among residents from central China, males, people who were middle-aged, elderly, highly educated, married, or widowed, those living far from healthcare facilities, and those without chronic disease. Male and highly educated subjects reported worse mobility, self-care, usual activities, pain/discomfort and anxiety/depression dimensions than the other respondents. Middle-aged (95% CI = 1.692, 2.851) and married respondents (95% CI = 1.692, 2.509) and respondents with chronic diseases (95% CI = 1.770, 2.849) were most affected in the anxiety/depression. CONCLUSIONS: The HRQOL of individuals living in poverty is lower than that of the general population, and the mental health dimension is most affected by poverty among respondents who are middle-aged or married and respondents with chronic diseases. The identification of populations that are more affected by poverty is critical to improve their HRQOL. Various associations have indicated the need for integrated policies and specific decision-making.


Assuntos
Pobreza/estatística & dados numéricos , Qualidade de Vida , Adolescente , Adulto , Ansiedade/epidemiologia , Estudos de Casos e Controles , China/epidemiologia , Doença Crônica/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/epidemiologia , População Rural , Inquéritos e Questionários , Adulto Jovem
17.
Health Qual Life Outcomes ; 18(1): 159, 2020 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-32460755

RESUMO

BACKGROUND: Physical symptoms such as fatigue, pain, digestive problems, and sleep disturbances are chief reasons individuals seek primary care, as they affect health-related quality of life. We investigated the associations between various combinations of these common symptoms and individuals' health-related quality of life. METHODS: This large-scale survey study of 1100 Koreans aged ≥19 years was conducted in 2017 using multi-stage stratified sampling based on region, sex, and age. Data were collected using questionnaires administered face-to-face; then, a linear regression analysis was performed to assess how the symptoms were related to participants' health-related quality of life. Complex symptoms were defined as co-occurrence of two or more of the four symptoms-fatigue, pain, digestive problems, and sleep disturbances. RESULTS: The most frequently observed stand-alone symptom was fatigue, while the most common combination was fatigue and pain. When examined individually, fatigue, digestive problems, and sleep disturbances were closely associated with mental health-related quality of life, and pain was associated with physical health-related quality of life. Complex symptoms were also related to health-related quality of life. Lower physical health-related quality of life was strongly associated when fatigue and pain or all four symptoms were co-occurring, and the lowest mental health-related quality of life was seen when all four symptoms were present, after adjusting for all variables. CONCLUSIONS: Symptoms can be present in various combinations and are significantly associated with health-related quality of life. Extra attention should be given to patterns accompanying fatigue and pain and to those involving more symptoms. This elucidated the characteristics of symptoms that affect the health-related quality of life of South Korean adults.


Assuntos
Fadiga/psicologia , Gastroenteropatias/psicologia , Dor/psicologia , Qualidade de Vida , Transtornos do Sono-Vigília/psicologia , Adulto , Idoso , Estudos Transversais , Fadiga/epidemiologia , Feminino , Gastroenteropatias/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Dor/epidemiologia , República da Coreia/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Inquéritos e Questionários , Adulto Jovem
18.
J Headache Pain ; 21(1): 45, 2020 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-32375641

RESUMO

BACKGROUND: Pain is a common symptom, often associated with neurological and musculoskeletal conditions, and experienced especially by females and by older people, and with increasing trends in general populations. Different risk factors for pain have been identified, but generally from studies with limited samples and a limited number of candidate predictors. The aim of this study is to evaluate the predictors of pain from a large set of variables and respondents. METHODS: We used part of the harmonized dataset of ATHLOS project, selecting studies and waves with a longitudinal course, and in which pain was absent at baseline and with no missing at follow-up. Predictors were selected based on missing distribution and univariable association with pain, and were selected from the following domains: Socio-demographic and economic characteristics, Lifestyle and health behaviours, Health status and functional limitations, Diseases, Physical measures, Cognition, personality and other psychological measures, and Social environment. Hierarchical logistic regression models were then applied to identify significant predictors. RESULTS: A total of 13,545 subjects were included of whom 5348 (39.5%) developed pain between baseline and the average 5.2 years' follow-up. Baseline risk factors for pain were female gender (OR 1.34), engaging in vigorous exercise (OR 2.51), being obese (OR 1.36) and suffering from the loss of a close person (OR 1.88) whereas follow-up risk factors were low energy levels/fatigue (1.93), difficulties with walking (1.69), self-rated health referred as poor (OR 2.20) or average to moderate (OR 1.57) and presence of sleep problems (1.80). CONCLUSIONS: Our results showed that 39.5% of respondents developed pain over a five-year follow-up period, that there are proximal and distal risk factors for pain, and that part of them are directly modifiable. Actions aimed at improving sleep, reducing weight among obese people and treating fatigue would positively impact on pain onset, and avoiding vigorous exercise should be advised to people aged 60 or over, in particular if female or obese.


Assuntos
Envelhecimento/fisiologia , Bases de Dados Factuais/tendências , Dor/diagnóstico , Dor/epidemiologia , Vigilância da População , Adulto , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/patologia , Peso Corporal/fisiologia , China/epidemiologia , Cognição/fisiologia , Europa (Continente)/epidemiologia , Exercício Físico/fisiologia , Feminino , Seguimentos , Nível de Saúde , Humanos , Estilo de Vida , Estudos Longitudinais , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Dor/fisiopatologia , Vigilância da População/métodos , Valor Preditivo dos Testes , Fatores de Risco , Fatores Sexuais , Adulto Jovem
19.
J Headache Pain ; 21(1): 59, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32471359

RESUMO

BACKGROUND: There is histological evidence of microstructural changes in the zygomaticotemporal branch of the trigeminal nerve in migraineurs. This raises the possibility that altered trigeminal nerve properties contribute to migraine pathophysiology. Whilst it is not possible to explore the anatomy of small trigeminal nerve branches it is possible to explore the anatomy of the trigeminal root entry zone using magnetic resonance imaging in humans. The aim of this investigation is to assess the microstructure of the trigeminal nerve in vivo to determine if nerve alterations occur in individuals with episodic migraine. METHODS: In 39 migraineurs and 39 matched controls, T1-weighted anatomical images were used to calculate the volume (mm3) and maximal cross-sectional area of the trigeminal nerve root entry zone; diffusion tensor images were used to calculate fractional anisotropy, mean diffusion, axial diffusion and radial diffusion. RESULTS: There were significant differences between the left and right nerve of controls and migraineurs with respect to volume and not cross-sectional area. Migraineurs displayed reduced axial diffusion in the right nerve compared to the left nerve, and reduced fractional anisotropy in the left nerve compared to left controls. Furthermore, although there were no differences in mean diffusion or radial diffusion, regional analysis of the nerve revealed significantly greater radial diffusion in the middle and rostral portion of the left trigeminal nerve in migraineurs compared with controls. CONCLUSIONS: Migraine pathophysiology is associated with microstructural abnormalities within the trigeminal nerve that are consistent with histological evidence of altered myelin and/or organization. These peripheral nerve changes may provide further insight into migraine pathophysiology and enable a greater understanding for targeted treatments of pain alleviation.


Assuntos
Imagem por Ressonância Magnética/métodos , Transtornos de Enxaqueca/diagnóstico por imagem , Nervo Trigêmeo/diagnóstico por imagem , Adulto , Anisotropia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos de Enxaqueca/epidemiologia , Dor/diagnóstico por imagem , Dor/epidemiologia
20.
BMC Public Health ; 20(1): 714, 2020 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-32429936

RESUMO

BACKGROUND: Self-medication (SM) is the practice of consuming medication without the consultation of physician. The drugs most commonly self-medicated are paracetamol, analgesics, ranitidine, oral rehydration solution and antibiotics. The objective of the study was to assess the SM status and its causes in Pokhara valley of Nepal. METHOD: The study was conducted among the people residing in Pokhara metropolitan city. The study duration was of 4 months from April to July, 2018. The study population were patients attending health general and oral health screening programs at Baidam, Birauta, Hemja and Pame areas of Pokhara. Structured questionnaire was used to collect demographics of the patients and the details of the usage of self-medication. RESULT: Out of 201 patients, 38.2% patients were found to be self-medicating. The most common illness sought for SM was ache (headache, body ache) in 50% subjects followed by cough and cold in 31% and gastritis in 23%. Paracetamol was the drug consumed by 16 subjects followed by nimesulide by 11. Lack of knowledge about the disadvantages of SM led to self-medication in 65% of respondents. The personnel most commonly consulted for medication were pharmacists (60%). CONCLUSION: The trend of SM is high in Pokhara valley. The comedics were consulted most often for SM due to lack of knowledge of consultation to physicians. The public should be made aware about SM.


Assuntos
Assistência Farmacêutica/estatística & dados numéricos , Encaminhamento e Consulta/estatística & dados numéricos , Automedicação/estatística & dados numéricos , Acetaminofen/uso terapêutico , Adulto , Analgésicos/uso terapêutico , Antibacterianos/uso terapêutico , Resfriado Comum/tratamento farmacológico , Resfriado Comum/epidemiologia , Tosse/tratamento farmacológico , Tosse/epidemiologia , Estudos Transversais , Feminino , Hidratação/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Nepal/epidemiologia , Dor/tratamento farmacológico , Dor/epidemiologia , Ranitidina/uso terapêutico , Inquéritos e Questionários
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