Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 7.323
Filtrar
1.
J Bodyw Mov Ther ; 39: 356-363, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38876652

RESUMO

The objective of this study is to evaluate the odds ratio of occurrence of pain, postural changes, and disabilities of violinists. Thirty-eight violinists were assessed. Photographs from anterior, posterior, and lateral views were taken and analyzed using Software of Postural Analysis. Pain was assessed by the Visual Analogue Pain Scale and the musculoskeletal disability of the arm, shoulder, and hand questionnaire (DASH). A logistic regression model was employed and all variables related to posture, age, gender, hours of practice, and duration of practice were considered. The results regarding the VAS and DASH were analyzed using multivariate techniques. The most important variables for the discrimination between the groups regarding the VAS scores were head and shoulder and thoracic kyphosis. For the DASH index, the key variables were the lateral spinal deviation and the head tilt. The odds ratio of occurrence pain was associated with the duration of the practice and the following postural variables: shoulder asymmetries, head postures, and lumbar lordosis. Scapular postures and thoracic kyphosis were associated with hours of practice, and the scapular postures with the duration of practice. This article provides new evidence of occurrence of pain, postural changes and disabilities in violinists. The odds ratio of occurrence pain was associated with the duration of the professional practice.


Assuntos
Música , Postura , Humanos , Masculino , Feminino , Adulto , Postura/fisiologia , Pessoa de Meia-Idade , Razão de Chances , Medição da Dor , Adulto Jovem , Cifose/epidemiologia , Cifose/fisiopatologia , Doenças Profissionais/epidemiologia , Doenças Profissionais/fisiopatologia , Dor/epidemiologia , Avaliação da Deficiência
2.
BMC Geriatr ; 24(1): 437, 2024 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-38760712

RESUMO

OBJECTIVES: Motoric cognitive risk syndrome (MCR) is a pre-dementia condition characterized by subjective complaints in cognition and slow gait. Pain interference has previously been linked with cognitive deterioration; however, its specific relationship with MCR remains unclear. We aimed to examine how pain interference is associated with concurrent and incident MCR. METHODS: This study included older adults aged ≥ 65 years without dementia from the Health and Retirement Study. We combined participants with MCR information in 2006 and 2008 as baseline, and the participants were followed up 4 and 8 years later. The states of pain interference were divided into 3 categories: interfering pain, non-interfering pain, and no pain. Logistic regression analysis was done at baseline to examine the associations between pain interference and concurrent MCR. During the 8-year follow-up, Cox regression analysis was done to investigate the associations between pain interference and incident MCR. RESULTS: The study included 7120 older adults (74.6 ± 6.7 years; 56.8% females) at baseline. The baseline prevalence of MCR was 5.7%. Individuals with interfering pain had a significantly increased risk of MCR (OR = 1.51, 95% CI = 1.17-1.95; p = 0.001). The longitudinal analysis included 4605 participants, and there were 284 (6.2%) MCR cases on follow-up. Participants with interfering pain at baseline had a higher risk for MCR at 8 years of follow-up (HR = 2.02, 95% CI = 1.52-2.69; p < 0.001). CONCLUSIONS: Older adults with interfering pain had a higher risk for MCR versus those with non-interfering pain or without pain. Timely and adequate management of interfering pain may contribute to the prevention and treatment of MCR and its associated adverse outcomes.


Assuntos
Dor , Humanos , Feminino , Masculino , Idoso , Estudos de Coortes , Idoso de 80 Anos ou mais , Dor/epidemiologia , Dor/diagnóstico , Dor/psicologia , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/psicologia , Disfunção Cognitiva/diagnóstico , Fatores de Risco , Síndrome , Seguimentos , Estudos Longitudinais , Vigilância da População/métodos
3.
BMC Musculoskelet Disord ; 25(1): 391, 2024 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-38762469

RESUMO

BACKGROUND: Pain is common in individuals with cerebral palsy (CP) and the most reported pain site is the foot/lower leg. We analyzed the prevalence of pain in the foot/lower leg and the associations with age, sex, gross motor function, and clinical findings in individuals with CP. METHOD: This was a cross-sectional register-study, based on data reported to the Swedish Cerebral Palsy Follow-up Program (CPUP). All participants in CPUP, four years-of-age or older, were included. Pearson chi-square tests and logistic regression were used to analyze the prevalence and degree of pain in the foot/lower leg. RESULTS: In total, 5,122 individuals were included from the CPUP database: 58% were males and 66% were under 18 years-of-age. Overall, 1,077 (21%) reported pain in the foot/lower leg. The odds ratios (ORs) of pain were higher in females (OR 1.31, 95% confidence interval (CI) 1.13-1.53), individuals who could ambulate (Gross Motor Function Classification System Level I (OR 1.84, CI 1.32-2.57) and II (OR 2.01, CI 1.46-2.79) compared to level V), and in individuals with decreased range of motion of the ankle (dorsiflexion 1-10 degrees (OR 1.43, CI 1.13-1.83) and ≤ 0 degrees (OR 1.46, CI 1.10-1.93) compared to ≥ 20 degrees). With increasing age the OR of pain increased (OR 1.02, CI 1.01-1.03) as well as the reported pain intensity (p < 0.001). CONCLUSIONS: Pain in the foot and lower leg appears to be a significant problem in individuals with CP, particularly in those who walk. As with pain in general in this population, both pain intensity and frequency increase with age. The odds of pain in the foot and lower leg were increased in individuals with limited dorsiflexion of the ankle. Given the cross-sectional design causality cannot be inferred and it is unknown if pain causes decreased range of motion of the ankle or if decreased range of motion causes pain. Further research is needed on causal pathways and importantly on prevention.


Assuntos
Paralisia Cerebral , Perna (Membro) , Sistema de Registros , Humanos , Paralisia Cerebral/epidemiologia , Paralisia Cerebral/complicações , Paralisia Cerebral/fisiopatologia , Masculino , Feminino , Estudos Transversais , Adulto , Adolescente , Criança , Adulto Jovem , Suécia/epidemiologia , Pré-Escolar , Prevalência , Pé/fisiopatologia , Pessoa de Meia-Idade , Dor/epidemiologia , Dor/diagnóstico , Dor/etiologia , Medição da Dor
4.
Glob Health Action ; 17(1): 2325728, 2024 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-38596846

RESUMO

OBJECTIVES: The study aimed to investigate the prevalence and factors associated with poor health-related quality of life in adults with cancer in Uganda. METHODS: This cross-sectional study surveyed 385 adult patients (95% response rate) with various cancers at a specialised oncology facility in Uganda. Health-related quality of life was measured using the EORTC QLQ-C30 in the Luganda and English languages. Predetermined validated clinical thresholds were applied to the instrument in order to identify patients with poor health-related quality of life, that is, functional impairments or symptoms warranting concern. Multivariable logistic regression was used to identify factors associated with poor health-related quality of life in six subscales: Physical Function, Role Function, Emotional Function, Social Function, Pain and Fatigue. RESULTS: The mean age of the patients was 48 years. The majority self-reported poor functioning ranging between 61% (Emotional Function) to 79% (Physical Function) and symptoms (Fatigue 63%, Pain 80%) at clinically concerning levels. These patients were more likely to be older, without formal education and not currently working. Being an inpatient at the facility and being diagnosed with cervical cancer or leukaemia was a predictor of poor health-related quality of life. CONCLUSION: Improvement of cancer care in East Africa requires a comprehensive and integrated approach that addresses various challenges specific to the region. Such strategies include investment in healthcare infrastructure, for example, clinical guidelines to improve pain management, and patient education and support services.


Main findings: The majority of adult patients attending specialized cancer care in Uganda report impaired physical and emotional functioning, and pain, at levels that merit clinical concern.Added knowledge: The large proportion of in- and outpatients with poor self-reported health-related quality of life indicates supportive care needs, exceeding corresponding figures from high-income settings.Global health impact for policy and action: Improvement of cancer care in East Africa requires a comprehensive approach that should include investment in healthcare infrastructure, e.g. clinical guidelines to improve pain management, and patient education and support services.


Assuntos
Qualidade de Vida , Neoplasias do Colo do Útero , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Qualidade de Vida/psicologia , Estudos Transversais , Uganda/epidemiologia , Dor/epidemiologia , Dor/psicologia , Inquéritos e Questionários , Fadiga/epidemiologia , Fadiga/etiologia , Fadiga/psicologia
5.
BMJ Open ; 14(4): e079923, 2024 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-38642997

RESUMO

OBJECTIVE: The objective of this study is to determine demographic and diagnostic distributions of physical pain recorded in clinical notes of a mental health electronic health records database by using natural language processing and examine the overlap in recorded physical pain between primary and secondary care. DESIGN, SETTING AND PARTICIPANTS: The data were extracted from an anonymised version of the electronic health records of a large secondary mental healthcare provider serving a catchment of 1.3 million residents in south London. These included patients under active referral, aged 18+ at the index date of 1 July 2018 and having at least one clinical document (≥30 characters) between 1 July 2017 and 1 July 2019. This cohort was compared with linked primary care records from one of the four local government areas. OUTCOME: The primary outcome of interest was the presence of recorded physical pain within the clinical notes of the patients, not including psychological or metaphorical pain. RESULTS: A total of 27 211 patients were retrieved. Of these, 52% (14,202) had narrative text containing relevant mentions of physical pain. Older patients (OR 1.17, 95% CI 1.15 to 1.19), females (OR 1.42, 95% CI 1.35 to 1.49), Asians (OR 1.30, 95% CI 1.16 to 1.45) or black (OR 1.49, 95% CI 1.40 to 1.59) ethnicities, living in deprived neighbourhoods (OR 1.64, 95% CI 1.55 to 1.73) showed higher odds of recorded pain. Patients with severe mental illnesses were found to be less likely to report pain (OR 0.43, 95% CI 0.41 to 0.46, p<0.001). 17% of the cohort from secondary care also had records from primary care. CONCLUSION: The findings of this study show sociodemographic and diagnostic differences in recorded pain. Specifically, lower documentation across certain groups indicates the need for better screening protocols and training on recognising varied pain presentations. Additionally, targeting improved detection of pain for minority and disadvantaged groups by care providers can promote health equity.


Assuntos
Transtornos Mentais , Saúde Mental , Feminino , Humanos , Processamento de Linguagem Natural , Promoção da Saúde , Transtornos Mentais/epidemiologia , Dor/epidemiologia , Registros Eletrônicos de Saúde
6.
Age Ageing ; 53(4)2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38610062

RESUMO

OBJECTIVE: Delirium and pain are common in older adults admitted to hospital. The relationship between these is unclear, but clinically important. We aimed to systematically review the association between pain (at rest, movement, pain severity) and delirium in this population. METHODS: PubMed, EMBASE, CINAHL, PsycINFO, Cochrane and Web of Science were searched (January 1982-November 2022) for Medical Subject Heading terms and synonyms ('Pain', 'Analgesic', 'Delirium'). Study eligibility: (1) validated pain measure as exposure, (2) validated delirium tool as an outcome; participant eligibility: (1) medical or surgical (planned/unplanned) inpatients, (2) admission length ≥ 48 h and (3) median cohort age over 65 years. Study quality was assessed with the Newcastle Ottawa Scale. We collected/calculated odds ratios (ORs) for categorical data and standard mean differences (SMDs) for continuous data and conducted multi-level random-intercepts meta-regression models. This review was prospectively registered with PROSPERO [18/5/2020] (CRD42020181346). RESULTS: Thirty studies were selected: 14 reported categorical data; 16 reported continuous data. Delirium prevalence ranged from 2.2 to 55%. In the multi-level analysis, pain at rest (OR 2.14; 95% confidence interval [CI] 1.39-3.30), movement (OR 1.30; 95% CI 0.66-2.56), pain categorised as 'severe' (OR 3.42; 95% CI 2.09-5.59) and increased pain severity when measured continuously (SMD 0.33; 95% CI 0.08-0.59) were associated with an increased delirium risk. There was substantial heterogeneity in both categorical (I2 = 0%-77%) and continuous analyses (I2 = 85%). CONCLUSION: An increase in pain was associated with a higher risk of developing delirium. Adequate pain management with appropriate analgesia may reduce incidence and severity of delirium.


Assuntos
Delírio , Pacientes Internados , Humanos , Idoso , Dor/diagnóstico , Dor/epidemiologia , Manejo da Dor , Hospitais , Delírio/diagnóstico , Delírio/epidemiologia
7.
J Pediatr Orthop ; 44(6): e478-e484, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38630916

RESUMO

BACKGROUND: The long-term radiological outcomes after the treatment of neonatal hip instability (NHI) in developmental dysplasia of the hip are unclear. Therefore, the prevalence of acetabular dysplasia at a mean age of 18 years after treatment was investigated. The relationship between acetabular dysplasia and hip discomfort has also been poorly established. Therefore, the differences in pain, hip-related quality of life (QOL), and hip impingement tests in hips with and without acetabular dysplasia were assessed. METHODS: All 127 patients treated for NHI from 1995 to 2001 at the study hospital and meeting the inclusion criteria were invited to participate in this population-based follow-up. Of these individuals, 88 (69.3%) participated. The lateral center-edge angle (LCEA), Sharp's angle (SA), and acetabular head index (AHI) were calculated for both hips from pelvic anterior-posterior radiographs. The Copenhagen Hip and Groin Outcome Score (HAGOS) questionnaire was completed for both hips separately; the total score, pain, and QOL subscores were calculated; and the impingement test was performed. RESULTS: The prevalence of acetabular dysplasia, defined as an LCEA <20°, was 3.4%. Only the mean AHI (81.1%, SD 5.3) differed (-5.08, 95% CI -5.77 to -4.38, P <0.001) from previously described gender-specific and side-specific means, whereas the mean LCEA and SA did not. The odds ratio for a positive hip impingement test was 2.8 (95% CI: 1.11-7.05, P = 0.029) for hips with an LCEA <25° compared to hips with LCEA ≥25°. The hips with an SA ≥45° had a mean of 7.8 points lower for the HAGOS pain subscore (95% CI: 4.2-11.4, P <0.001) and a mean of 6.1 points lower for the HAGOS QOL subscore (95% CI: 2.1-10.2, P = 0.003) compared with hips with an SA <45°. CONCLUSIONS: The prevalence of acetabular dysplasia was low after treatment for NHI. Acetabular dysplasia seems to be as common in the general population as for those treated for NHI based on the LCEA. Only an SA ≥45° resulted in slightly more pain and lower hip-related QOL.


Assuntos
Acetábulo , Instabilidade Articular , Qualidade de Vida , Humanos , Feminino , Masculino , Prevalência , Adolescente , Seguimentos , Instabilidade Articular/epidemiologia , Recém-Nascido , Displasia do Desenvolvimento do Quadril , Luxação Congênita de Quadril/terapia , Luxação Congênita de Quadril/epidemiologia , Radiografia , Inquéritos e Questionários , Adulto Jovem , Dor/etiologia , Dor/epidemiologia , Articulação do Quadril/diagnóstico por imagem , Articulação do Quadril/fisiopatologia
8.
Am J Otolaryngol ; 45(4): 104300, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38640810

RESUMO

PURPOSE: The experience of long-term pain in head and neck cancer (HNC) survivors is important but has received less attention in the HNC literature. The present study sought to examine the prevalence of pain from 2 to 5 years postdiagnosis and its association with HNC-specific health-related quality of life. MATERIALS & METHODS: Prospective observational study at a single-institution tertiary care center. Pain was measured using a single item ranging from 0 to 10 with 0 representing no pain and 10 representing worst pain possible at 2 through 5 years postdiagnosis. HNC-specific HRQOL was measured using the Head and Neck Cancer Inventory (HNCI). RESULTS: Pain reports were consistent across time. At 2 years postdiagnosis (N = 581), 27.6 % experienced at least some pain with 14.3 % reporting moderate or severe pain. At 3 years postdiagnosis (N = 417), 21.4 % experienced at least some pain with 14.2 % indicating moderate or severe pain. At 4 years postdiagnosis (N = 334), 26.7 % experienced at least some pain with 15.9 % reporting moderate or severe pain. At 5 years postdiagnosis (N = 399), 30.5 % experienced at least some pain with 17.5 % indicating moderate or severe pain. In general, across all four HNCI domains, those in the moderate and severe pain categories largely failed to reach 70 which is indicative of high functioning on the HNCI. CONCLUSIONS: Pain is a considerable issue in long-term HNC survivors up to 5 years postdiagnosis. More research is needed to understand correlates of pain after treatment, including opportunities for screening and intervention, to improve outcomes and optimize recovery in HNC.


Assuntos
Sobreviventes de Câncer , Neoplasias de Cabeça e Pescoço , Qualidade de Vida , Humanos , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Sobreviventes de Câncer/estatística & dados numéricos , Idoso , Fatores de Tempo , Medição da Dor , Adulto , Dor/epidemiologia , Dor/etiologia
9.
J Affect Disord ; 355: 290-298, 2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38556095

RESUMO

BACKGROUND: This study extends from the 2015 Shandong Province Epidemiological Survey of Mental Disorders in adults aged 18 and above. Over five years, it investigates pain characteristics and influencing factors in individuals with depressive disorders in Shandong Province. METHODS: The study encompasses 871 individuals who met DSM-IV criteria for depressive disorders in 2015. Using 1:1:1 matching by gender, age, and residence, 825 non-afflicted individuals were selected as high-risk controls, and 825 screening-negative individuals became low-risk controls. A follow-up study in 2020 involved 1848 participants. Survey tools included a general information questionnaire, General Health Questionnaire-12 (GHQ-12), SCID-I/P, Global Pain Scale (GPS), Quality of Life Questionnaire (QLQ), PSQI, MoCA, and clinical data questionnaire. RESULTS: GPS scores in the current depressive group were higher than in non-current depressive group (Z = 14.36, P < 0.01). GPS scores in study group exceeded those in high-risk and low-risk control groups (H = 93.71, P < 0.01). GPS scores in non-remission group were higher than in the remission group (Z = 8.90, P < 0.01). Regression analysis revealed positive correlations between GPS scores and physical illnesses, current depression, incumbency, GHQ-12 total score, and PSQI total score. Negative correlations were observed with QLQ total score and MoCA total score. LIMITATIONS: The study could not assess pain during the 2015 survey, limiting controlled pain analysis before and after five years. CONCLUSION: Depression sufferers may experience prolonged heightened pain, potentially relieved when depression subsides. Individual pain is influenced by depression, physical illnesses, sleep quality, quality of life, cognitive function, gender, residence, and occupation.


Assuntos
Transtorno Depressivo , Transtornos Mentais , Adulto , Humanos , Seguimentos , Qualidade de Vida/psicologia , Inquéritos e Questionários , Dor/epidemiologia , China/epidemiologia , Transtorno Depressivo/epidemiologia
10.
Intern Med J ; 54(4): 671-674, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38450876

RESUMO

A hospital-wide point prevalence study investigated frailty and pain in patients with a cancer-related admission. Modifiable factors associated with frailty in people with cancer were determined through logistic regression. Forty-eight patients (19%) with cancer-related admissions were 2.65 times more likely to be frail and 2.12 more likely to have moderate pain. Frailty and pain were highly prevalent among cancer-related admissions, reinforcing the need for frailty screening and importance of pain assessment for patients with cancer.


Assuntos
Fragilidade , Neoplasias , Humanos , Idoso , Fragilidade/diagnóstico , Fragilidade/epidemiologia , Prevalência , Idoso Fragilizado , Hospitalização , Dor/epidemiologia , Avaliação Geriátrica , Neoplasias/complicações , Neoplasias/epidemiologia , Neoplasias/terapia
11.
Age Ageing ; 53(3)2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38521972

RESUMO

BACKGROUND: Few studies have examined the associations between pain trajectories and cognitive function in older adults. This study explored the associations between pain trajectories and different cognitive domains in older adults from a network perspective. METHODS: Data on pain trajectories were derived from the Health and Retirement Study between 2010 and 2020 using latent class growth analyses. Measurements of key cognition domains, including memory, attention, calculation, orientation and language, were included. Linear regression and network analysis were performed to evaluate the associations between different pain trajectories and cognition. RESULTS: A total of 9,551 older adults were included in this study and three trajectories of pain were identified. After controlling for the covariates, persistent severe pain trajectory was associated with poorer overall cognition, memory and calculation ability when compared to mild or non-persistent pain trajectory. In the pain and cognition network model, memory (expected influence (EI) = 0.62), language (EI = 0.58) and calculation (EI = 0.41) were the most central domains. CONCLUSIONS: Pain trajectories appeared stable over time among older adults in this study. Severity of persistent pain was an important risk factor for poor cognition, especially in relation to memory and calculation domains. Interventions targeting memory, language and calculation domains might be useful in addressing cognitive decline in older adults with persistent pain.


Assuntos
Transtornos Cognitivos , Disfunção Cognitiva , Humanos , Idoso , Estudos de Coortes , Cognição , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/epidemiologia , Dor/diagnóstico , Dor/epidemiologia , Estudos Longitudinais
12.
Medicine (Baltimore) ; 103(13): e37581, 2024 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-38552034

RESUMO

Persons with HIV (PWH) experience high levels of pain. We examined the relationship of pain severity with use of cannabis and prescription opioids among PWH. This cross-sectional study evaluated associations between self-reported pain (moderate/severe vs mild/none) and cannabis and prescription opioid use in a primary care sample of PWH enrolled in an alcohol use treatment study at Kaiser Permanente, San Francisco. Prevalence ratios (PR) for moderate/severe pain associated with cannabis, opioid use, or both in the prior 30 days were obtained from Poisson regression models. Adjusted models included race/ethnicity, education, employment, HIV ribonucleic acid levels, depression, and anxiety. Overall, 614 PWH completed baseline questionnaires from May 2013 to May 2015, among whom 182/614 (29.6%) reported moderate/severe pain. The prevalence of moderate/severe pain varied by substances: 19.1% moderate/severe pain among study participants who reported neither cannabis or opioids, 30.2% for cannabis alone, 41.2% for opioids alone, and 60.9% for those reporting both substances. In adjusted models, compared with PWH who reported neither substance (reference), prevalence of moderate/severe pain was higher for those using cannabis alone (PR 1.54; 95% CI 1.13-2.09), opioids alone (PR 1.96; 95% CI 1.31-2.94), and those reporting both (PR 2.66; 95% CI 1.91-3.70). PWH who reported opioid and/or cannabis use were more likely to report moderate/severe pain compared with PWH who did not report use of these substances. To improve patient care, it is vital to assess patients' approaches to pain management including substance use and target appropriate interventions to reduce pain in PWH.


Assuntos
Cannabis , Infecções por HIV , Alucinógenos , Transtornos Relacionados ao Uso de Opioides , Humanos , Analgésicos Opioides/uso terapêutico , Estudos Transversais , Autorrelato , Medição da Dor , Dor/tratamento farmacológico , Dor/epidemiologia , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , California/epidemiologia , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Infecções por HIV/tratamento farmacológico , Atenção Primária à Saúde
13.
J Occup Environ Med ; 66(5): 439-444, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38446720

RESUMO

OBJECTIVE: Do the 3.5 million US veterans, who primarily utilize private healthcare, have similar burn pit exposure and disease compared to the VA Burn Pit registry? METHODS: This is an online volunteer survey of Gulf War and Post-9/11 veterans. RESULTS: Burn pit exposure had significantly higher odds of extremity numbness, aching pain and burning, asthma, chronic obstructive pulmonary disease, interstitial lung disease, constrictive bronchiolitis, pleuritis, and pulmonary fibrosis. Chi-square did not reveal a difference in burn pit exposure and cancer diagnoses. CONCLUSIONS: These data demonstrate increased risk of neurological symptoms associated with burn pit exposure, which are not covered in the 2022 federal Promise to Address Comprehensive Toxics Act. Additional data will allow for the continued review and consideration for future medical benefits.


Assuntos
Veteranos , Humanos , Masculino , Estados Unidos/epidemiologia , Veteranos/estatística & dados numéricos , Pessoa de Meia-Idade , Feminino , Adulto , Prevalência , Asma/epidemiologia , Idoso , Hipestesia/epidemiologia , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doenças Pulmonares Intersticiais/epidemiologia , Fibrose Pulmonar/epidemiologia , Dor/epidemiologia , Queimaduras/epidemiologia , Queima de Resíduos a Céu Aberto
14.
Aging Clin Exp Res ; 36(1): 80, 2024 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-38546804

RESUMO

BACKGROUND: We assessed whether clinical, functional and behavioral factors were associated with the decrease in mobility trajectories reported in older people at risk of sarcopenia (RS) and without risk of sarcopenia (NRS) during COVID-19 pandemic. METHODS: We prospectively analyzed mobility trajectories reported in older adults with RS and NRS over 16-month follow-up (Remobilize study). The self-perceived risk of sarcopenia and mobility were assessed using the SARC-F and the Life-Space Assessment (LSA) tools, respectively. Gender, age, comorbidities, pain, functional limitation, physical activity (time spent in walking; min/week), and sitting time (ST; hours/day) were assessed. We used a multilevel model to determine changes in mobility between groups and over time. RESULTS: Mobility was lower in RS than in NRS. Older people at RS, who were women, aged 70-79 years and 80 years or older, inactive, and with moderate to severe functional limitation experienced reduced mobility trajectories reported over the pandemic. For older people at NRS, trajectories with reduce mobility reported were experienced by women with comorbidities, for those with insufficient walking time and aged 70-79 years; aged 70-79 years and with ST between 5 and 7 hours/day; for those with insufficient walking time and increased ST; and for those with pain and increased ST. CONCLUSION: Mobility trajectories reported in older people at risk of sarcopenia were negatively influenced by insufficient level of physical inactivity and pre-existing moderate to severe functional limitation. Health and social interventions should be target to avoid mobility limitation during and after the COVID-19 pandemic.


Assuntos
COVID-19 , Sarcopenia , Humanos , Feminino , Idoso , Masculino , Sarcopenia/epidemiologia , Pandemias , COVID-19/epidemiologia , Exercício Físico , Dor/epidemiologia , Limitação da Mobilidade
15.
Sci Rep ; 14(1): 5613, 2024 03 07.
Artigo em Inglês | MEDLINE | ID: mdl-38453981

RESUMO

Adequate analgesia is one of the most important interventions in emergency medicine. However, studies suggest that many patients are undertreated for pain. There can be many reasons why patients assess their pain differently to the paramedics. This study aimed to assess the differences in pain ratings between patients and paramedics and factors influencing them in prehospital emergencies. This prospective cross-sectional observational study included patients treated and transported by paramedics or paramedics and emergency physicians of the German Red Cross in Reutlingen, Germany. This study included 6,365 patients. The prevalence of pain was 49.7%. Among patients with a self-reported numerical rating scale (NRS) > 0, the mean patient pain rating was NRS 4.2 ± 2.7, while the mean paramedic pain rating was NRS 3.6 ± 2.4 (p < 0.001). Approximately 11.8% (n = 751) of patients reported subjectively unbearable pain. Patients reported a mean NRS of 7.7 ± 1.8 for unbearable pain, but a mean NRS of 3.3 ± 2.0 for bearable pain (p < 0.001). The difference in pain ratings between patients and paramedics increased with pain severity. Univariate analysis showed that there were no gender differences, but the difference in pain rating was influenced by patient age (p < 0.001) and paramedic age (p = 0.042). The differences in pain ratings were particularly pronounced for abdominal diseases (p < 0.001) and trauma (p < 0.001). There is a difference in pain ratings between patients and paramedics, which increases with pain severity and appears to be associated with the patient's age and the paramedic's age. To determine the desire and need for analgesics, the question about unbearable pain is a good addition to the NRS.


Assuntos
Serviços Médicos de Emergência , Paramédico , Humanos , Medição da Dor , Estudos Transversais , Prevalência , Estudos Prospectivos , Dor/diagnóstico , Dor/epidemiologia
16.
Soc Sci Med ; 346: 116692, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38460426

RESUMO

Current studies have indicated that the number of individuals living with pain has risen in recent years, with nearly half of all adults in some countries living with some form of pain. Such trends have prompted researchers to explore differences in pain across different sociodemographic groups, with a dominant focus on educational attainment. However, much of the studies fail to consider the confounding role of early life characteristics, such as family background. Using data on over 400,000 individuals from the UK Biobank, we look at how educational attainment is associated with nine different domains of pain (headache, facial, neck, back, hip, knee, stomach, all over, and no pain). Ultimately, we find that compared to those with no educational credentials, education is associated with anywhere between a 0.1-15% change in the likelihood of reporting pain, depending on pain type and education level, with the greatest change occurring in those with the highest level. Yet, when accounting for family background characteristics in the form of sibling fixed effects, nearly all relationships between education and pain fell by either 50% or were eliminated. We ultimately conclude that failure to consider early life characteristics, such as family background characteristics may lead to inflated estimates of pain, and that future research should delve into early life exposures and their influence on pain in adulthood.


Assuntos
Sucesso Acadêmico , Adulto , Humanos , Escolaridade , Dor/epidemiologia , Características da Família , Irmãos
17.
Headache ; 64(3): 306-316, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38440947

RESUMO

OBJECTIVE: We aimed to examine factors associated with frequent headache remission in schoolchildren aged 10-18 years. BACKGROUND: Frequent headache is a common health problem in adolescence, and some individuals in this population experience remission. Factors preceding headache remission as opposed to ongoing headache, and their development over time, have not been examined extensively. METHODS: Data were derived from a large school sample (N = 2280). Over the course of 1 year, n = 156 adolescents experienced remission from frequent headaches, while n = 125 adolescents continued to have frequent headaches throughout the year. In this longitudinal case-control study, we predicted headache remission using demographic, pain, psychosocial, sleep, and physiological characteristics. Additionally, we sought to explore the development of psychosocial, sleep, and physiological characteristics in relation to remitted versus ongoing headache over the 1-year period. RESULTS: A model containing the variables sex (odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.248-0.76, p = 0.003), headache intensity (OR = 0.85, 95% CI = 0.73-0.99, p = 0.035), anxiety score (OR = 0.92, 95% CI = 0.85-1.01, p = 0.071), and depression score (OR = 0.94, 95% CI = 0.89-1.00, p = 0.041) predicted the outcome variable (remitted vs. non-remitted headache), explaining 17% of the variance in group membership. Schoolchildren reporting remitted headache at the end of the year exhibited lower depression (F[1, 557.01] = 45.77, p < 0.001) and anxiety scores (F[1, 557.01] = 21.72, p < 0.001), higher school satisfaction (F[1, 209.46] = 7.15, p = 0.008), and fewer difficulties falling asleep (F[1, 856.52] = 41.21, p < 0.001) or sleeping through the night (F[1, 731.12] = 26.42, p < 0.001) throughout the year compared to those with non-remitted headache. Depression scores declined significantly over the year in the group with remitted headache, whereas these scores remained constant in the group with non-remitted headache. CONCLUSION: Our results suggest a correlation between headache remission and male sex, improved mental health, and reduced pain-related burden. Moreover, there was an observed decline in symptoms of depression during headache remission. Psychotherapy may be a promising treatment strategy for addressing frequent headaches reported by children and adolescents.


Assuntos
Depressão , Cefaleia , Adolescente , Humanos , Masculino , Criança , Estudos de Casos e Controles , Depressão/epidemiologia , Depressão/complicações , Cefaleia/epidemiologia , Cefaleia/terapia , Cefaleia/diagnóstico , Dor/epidemiologia , Estudos Longitudinais
18.
Artigo em Inglês | MEDLINE | ID: mdl-38428027

RESUMO

OBJECTIVES: Conscientiousness is associated with positive health behaviors and outcomes and has been shown to increase as individuals age. Both age and Conscientiousness affect pain, a highly prevalent correlate of aging. This study investigated the effect of Conscientiousness on the relationship between pain and pain interference and vice versa among older adults, who experience pain and functional limitations disproportionately compared with younger adults. METHODS: A total of 196 community-dwelling older adults (Mage = 73) provided pain and interference ratings semiannually for up to 10 years. Conscientiousness was assessed at the first visit and, on average, 7.6 years later. Multilevel models tested the effect of Conscientiousness on the relationship between pain and interference. Hierarchical regression modeled changes in Conscientiousness. RESULTS: Across all pain levels, higher Conscientiousness was associated with less pain interference (γ02 = -0.126, SE = 0.048, p < .01, 95% confidence intervals (95% CI) [-0.22, -0.03]). This effect was more pronounced at higher levels of pain and older age. Conscientiousness increased slightly over time, but older baseline age (b = -0.01, 95% CI [-0.03, -0.001], R2 = 0.02) and more mean pain interference over the study period (b = -0.17, 95% CI [-0.30, -0.03], R2 = 0.03) were associated with less increase in Conscientiousness at follow-up. DISCUSSION: Higher pain and older age are associated with more pain interference, and Conscientiousness provided the most protection for these same individuals-those with higher pain and older age. Conscientiousness facilitated reduced interference, which may feed forward into higher Conscientiousness, potentially shaping a cycle between personality and health that extends through older adulthood.


Assuntos
Envelhecimento , Personalidade , Humanos , Idoso , Dor/epidemiologia , Comportamentos Relacionados com a Saúde , Vida Independente
19.
Br J Anaesth ; 132(6): 1285-1292, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38521656

RESUMO

BACKGROUND: Chronic pain after injury poses a serious health burden. As a result of advances in medical technology, ever more military personnel survive severe combat injuries, but long-term pain outcomes are unknown. We aimed to assess rates of pain in a representative sample of UK military personnel with and without combat injuries. METHODS: We used data from the ADVANCE cohort study (ISRCTN57285353). Individuals deployed as UK armed forces to Afghanistan were recruited to include those with physical combat injuries, and a frequency-matched uninjured comparison group. Participants completed self-reported questionnaires, including 'overall' pain intensity and self-assessment of post-traumatic stress disorder, anxiety, and depression. RESULTS: A total of 579 participants with combat injury, including 161 with amputations, and 565 uninjured participants were included in the analysis (median 8 yr since injury/deployment). Frequency of moderate or severe pain was 18% (n=202), and was higher in the injured group (n=140, 24%) compared with the uninjured group (n=62, 11%, relative risk: 1.1, 95% confidence interval [CI]: 1.0-1.2, P<0.001), and lower in the amputation injury subgroup (n=31, 19%) compared with the non-amputation injury subgroup (n=109, 26%, relative risk: 0.9, 95% CI: 0.9-1.0, P=0.034). Presence of at least moderate pain was associated with higher rates of post-traumatic stress (RR: 3.7, 95% CI: 2.7-5.0), anxiety (RR: 3.2, 95% CI: 2.4-4.3), and depression (RR: 3.4, 95% CI: 2.7-4.5) after accounting for injury. CONCLUSION: Combat injury, but not amputation, was associated with a higher frequency of moderate to severe pain intensity in this cohort, and pain was associated with adverse mental health outcomes.


Assuntos
Campanha Afegã de 2001- , Militares , Humanos , Masculino , Militares/psicologia , Militares/estatística & dados numéricos , Reino Unido/epidemiologia , Adulto , Estudos de Coortes , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto Jovem , Ansiedade/epidemiologia , Ansiedade/psicologia , Depressão/epidemiologia , Depressão/psicologia , Ferimentos e Lesões/psicologia , Ferimentos e Lesões/epidemiologia , Dor Crônica/epidemiologia , Dor Crônica/psicologia , Dor/epidemiologia , Dor/psicologia , Dor/etiologia , Medição da Dor/métodos
20.
BMC Musculoskelet Disord ; 25(1): 219, 2024 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-38500099

RESUMO

BACKGROUND: Pain in multiple body sites is common and often persistent. The purpose of this prospective study was to examine the change in the number of pain sites (NPS) over time and to evaluate to which extent clinical, demographic, lifestyle and health-related factors predict a change in NPS. METHODS: This was a population-based longitudinal cohort study of adults (n = 2,357). Data on pain, demographic, lifestyle, and health-related variables were collected by questionnaires in 2008 and 2020 and register data from 2006 to 2017. Data was analysed with linear regression. RESULTS: We found a mean decrease in NPS over the 12-year follow-up period (-0.36 (95% CI; -0.44; -0.27) and 56% of this sample reported no change or only one pain site increase/decrease over 12 years. While participants reporting pain for less than 3 months at baseline had almost no change in NPS (-0.04 (95% CI; -0.18; 0.10)), participants with pain for longer than 3 months decreased by -0.51 (95% CI; -0.62; -0.41). Age at baseline (20-49 years), pain intensity, and obesity (BMI ≥ 30) were associated with an increase in NPS over the follow-up period. CONCLUSIONS: NPS is relatively stable over time. We found a small mean decrease in NPS over 12 years varying between participants with pain for longer than 3 months and pain for less than 3 months respectively. The results also indicate that pain intensity, age, and obesity could be relevant factors to consider when predicting change in NPS.


Assuntos
Obesidade , Dor , Adulto , Humanos , Adulto Jovem , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Longitudinais , Dor/diagnóstico , Dor/epidemiologia , Obesidade/diagnóstico , Obesidade/epidemiologia , Inquéritos e Questionários
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...