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Calderón-Larrañaga, Amaia, Laura Pérez, Davide Vetrano, Federico Triolo, Linnea Sjöberg, Alexander Darin-Mattsson, Marco Inzitari, and Shireen Sindi. "Sleep Disturbances and the Speed of Multimorbidity Development in Old Age." Innovation in Aging 5, Supplement_1 (December 1, 2021): 377. http://dx.doi.org/10.1093/geroni/igab046.1462.
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Abstract Sleep disturbances are prevalent among older adults and are associated with various individual diseases. The goal of this study was to investigate whether sleep disturbances are associated with the speed of multimorbidity development among older adults. Data were gathered from the Swedish National study of Aging and Care in Kungsholmen (SNAC-K), an ongoing population-based study of subjects aged 60+ (N=3363). The study included a subsample (n=1189) without multimorbidity at baseline (<2 chronic diseases). Baseline sleep disturbances were assessed using the Comprehensive Psychiatric Rating Scale, and categorized as none, mild, moderate-severe. The number of chronic conditions throughout the nine-year follow-up was obtained from clinical examinations. Linear mixed models were used to study the association between sleep disturbances and the speed of chronic diseases accumulation, adjusting for sex, age, education, physical activity, smoking, alcohol consumption, depression, pain, and psychotropic drug use. We repeated the analyses including only cardiovascular, neuropsychiatric, and musculoskeletal diseases as the outcome. Moderate-severe sleep disturbances were associated with a higher speed of chronic disease accumulation (ß/year=0.142, p=0.008), regardless of potential confounders. Significant positive associations were also found between moderate-severe sleep disturbances and neuropsychiatric (ß/year=0.041, p=0.016) and musculoskeletal (ß/year=0.038, p=0.025) disease accumulation, but not with cardiovascular diseases. Results remained stable when participants with baseline dementia, cognitive impairment, or depression were excluded. The finding that sleep disturbances are associated with faster chronic disease accumulation points towards the importance of early detection and treatment of sleep disturbances as a possible strategy to reduce chronic multimorbidity among older adults.
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Elistratov, Dmitry G. "Application of bioregulatory osteoprotectors in old age to reduce drug load in diseases of the musculoskeletal system." Meditsinskaya sestra 24, no. 3 (2022): 41–45. http://dx.doi.org/10.29296/25879979-2022-03-08.
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Elistratov, Dmitry G. "Application of bioregulatory osteoprotectors in old age to reduce drug load in diseases of the musculoskeletal system." Meditsinskaya sestra 24, no. 3 (2022): 41–45. http://dx.doi.org/10.29296/25879979-2022-03-08.
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Elistratov, Dmitry G. "Application of bioregulatory osteoprotectors in old age to reduce drug load in diseases of the musculoskeletal system." Meditsinskaya sestra 24, no. 3 (2022): 41–45. http://dx.doi.org/10.29296/25879979-2022-03-08.
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Rodionov, Stanislav. "Indicator of geoecological assessment of the region - population health." E3S Web of Conferences 244 (2021): 01002. http://dx.doi.org/10.1051/e3sconf/202124401002.
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The article shows that an effective indicator of the level of pollution of air, water and soil with toxic compounds of anthropogenic origin is a health of the population in different age groups. As eco-indicators, it is proposed to use diseases of the respiratory system for people under 18 years old, the circulatory and digestive systems - 18-56 years old, the musculoskeletal system - over 56 years old. To carry out ecological diagnostics of negative changes in the natural environment of urbanized areas of small towns, we propose to assess the response (reaction) – hospitalization rate in different age groups of the population: under 18 years old, 19-55 years old, and over 56 years old.
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Bolobonkina, Tatyana A., Aleksej A. Dementyev, and Natalya V. Minaeva. "Prevalence and risk of chronic diseases in medical personnel of mobile ambulance teams." I.P. Pavlov Russian Medical Biological Herald 29, no. 4 (December 15, 2021): 483–88. http://dx.doi.org/10.17816/pavlovj64284.
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Introduction: Medical workers of mobile ambulance teams (MATs) are at a high risk of exposure to harmful working conditions, leading to the development of chronic diseases (CDs).
Aim: To study the prevalence and risks of the development of CDs according to the results of a sociological survey among medical workers of MATs.
Materials and methods: The method used for the sociological research was based on a specially designed questionnaire using Google Forms electronic service. The survey was participated by 176 medical workers. The average age of the respondents was 40.58 14.01 years, of which 143 were women and 33 were men.
Results: Of the majority of the respondents (63.6%), 51.5% were 1825 years old with working period 5 years, who had CDs; 89.5% were 5160 years old, and 100% were 61 years old. The most common forms of CDs were diseases of the musculoskeletal system, digestive organs, respiratory organs, urogenital system, and circulatory system, and the prevalence ranged from 25.6 to 15.3 per 100 respondents. In the total cohort, 74.8% had chronic morbidity. The medical personnel of general ambulance teams had significantly higher relative risk (RR) of CDs (2.449 [95% confidence interval, CI 1.7013.525]) than those of specialized ambulance teams. Gender and occupational differences in the development of musculoskeletal pathologies were found, with higher RRs among women (RR 4.510 [95% CI 1.15517.610]) and medical personnel of MATs (RR 1.874 [95% CI 1.0413.374]).
Conclusions: The prevalence of certain CDs among medical workers of MATs depends on the duration of contact with occupational factors, gender, and age of the workers.
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Gromakina, E. V., N. V. Tyunina, E. D. Egorova, and E. A. Sozurakova. "Pathogenetic aspects of cataract in comorbid conditions." Modern technologies in ophtalmology, no. 5 (September 30, 2022): 65–68. http://dx.doi.org/10.25276/2312-4911-2022-5-65-68.
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Relevance. Research by ophthalmologists, biologists, biochemists, biophysicists, physiologists have shown the significance of xeno- and endobiotic effects on the induction of cataracts and other degenerative diseases of the structures and membranes of the eye. Objective research goal was an evaluation of comorbid background in people of different ages with a diagnosis of senile cataract. Material and methods an analysis of the case histories of 173 patients of an independent sample with a diagnosis of "senile cataract" admitted for planned inpatient surgical treatment was carried out. The evaluation was carried out by decades of human life: younger than 40 years old, 41–50 years old, 51–60 years old, 61–70 years old, 71–80 years old and over 80 years old. The Charlson method was used to calculate the comorbidity index. Results patients who had senile cataract and concomitant somatic diseases, the most frequent- diseases of the cardiovascular system – 129 (74.6 %); violation of carbohydrate metabolism – 35 (20.2 %); diseases of the central nervous system – 33 (19.1 %); musculoskeletal system – 30 (17.3 %); diseases of the respiratory system – 19 (11.0 %). Conclusions. 1. A human's age of 51–60 years should be considered critical for the occurrence of senile cataract. 2. In the decade of life 51–60 years, there is an increase in persons with senile cataract by 3.3 and the frequency of concomitant somatic pathology (according to the index of comorbidity) by 2.25. Keywords: senile cataract, age, somatic diseases, index of comorbidity
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Pilipenko, A., V. Mazurov, and I. Gaydukova. "AB1208 FREQUENCY OF MUSCULOSKELETAL AND OTHER EXTRA-INTESTINAL SYMPTOMS IN PATIENTS WITH CELIAC DISEASE." Annals of the Rheumatic Diseases 81, Suppl 1 (May 23, 2022): 1719.1–1719. http://dx.doi.org/10.1136/annrheumdis-2022-eular.4278.
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BackgroundCeliac disease (CD) is one of the most common gastrointestinal tract diseases, in adults and children. Prevalence of CD is 1-3% [2]. The most common symptoms of CD are gastrointestinal symptoms. At the same time, celiac disease may manifest with extraintestinal symptoms, including the musculoskeletal, nervous, reproductive system, and skin, especially when it debuts at a late age [1,2]. However, data about musculoskeletal manifestations of CD are limited.ObjectivesTo show the frequency of musculoskeletal complaints and their peculiarities in patients with CD.MethodsData from 94 patients with diagnosed by gastroenterologist celiac disease were collected with the on-lain survey. All the patients were positive in CD-related immunological and genetic tests and had biopsy established CD.ResultsТhe average age of respondents is 37,52 ± 11,2 years, women 79 (84,1%), men 15 (15,9%). Among 94 respondents 0.1% do not follow a gluten-free diet, 10.6% <1 year, 25.5% from 1 to 3 years, 11.7% – 4-5 years, 28.7% are on a gluten-free diet >5 years, 14.9% – 10-15 years, 8.5% > 15 years. Gastrointestinal symptoms have started at the age < 10 years old in 59.6% of patients, in 4.2% in 11-16 years old, 13.8% at the age 17-25 years old, 12.8% at the age 26-40 years old, 9.6% had late CD onset (>40 years old).Extraintestinal symptoms such as drowsiness were noted by 46.8 %, headaches by 40.4%, weakness by 59.6%, irritability by 57.4% of respondents. Lack of coordination was noticed in 18.1% of cases, dizziness in 22.3%, 57.4% have numbness, decreased sensitivity, and tingling feeling in the limbs. Joint pain had 54.3% of the patients with CD (Figure 1).Figure 1.Frequency of pain in different jointsThe maximal intensity of pain was noticed in the morning (8.5%) or late night (13.8%) times and fulfilled inflammatory pain criteria (ASAS). In 17% was noticed interrelation between gluten-free diet violation and the appearance of joint pain. In 26.6% was noticed signs of enthesitis. Weakness of arms was noticed by 39.4% of respondents. Non-steroidal anti-inflammatory drugs (NSAIDs) were started by 35.1% of patients, without any improvement in 66% of cases.ConclusionPatients’ surveys showed that musculoskeletal symptoms in patients with celiac disease are not a rare problem and they are comparable with the frequency of neurological symptoms. Additional research is necessary for a better understanding of the nature of musculoskeletal involvement in celiac disease.References[1]Admou, B., et al. https://doi.org/10.1155/2012/637187.[2]Laurikka P., et al. https://doi.org/10.3390/nu10081015Disclosure of InterestsNone declared
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Solovieva, Svetlana, Karina Undem, Daniel Falkstedt, Gun Johansson, Petter Kristensen, Jacob Pedersen, Eira Viikari-Juntura, Taina Leinonen, and Ingrid Sivesind Mehlum. "Utilizing a Nordic Crosswalk for Occupational Coding in an Analysis on Occupation-Specific Prolonged Sickness Absence among 7 Million Employees in Denmark, Finland, Norway and Sweden." International Journal of Environmental Research and Public Health 19, no. 23 (November 25, 2022): 15674. http://dx.doi.org/10.3390/ijerph192315674.
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We identified occupations with a high incidence of prolonged sickness absence (SA) in Nordic employees and explored similarities and differences between the countries. Utilizing data from national registers on 25–59-year-old wage-earners from Denmark, Finland, Norway and Sweden, we estimated the gender- and occupation-specific age-adjusted cumulative incidence of SA due to any cause, musculoskeletal diseases and mental disorders. To increase the comparability of occupations between the countries, we developed a Nordic crosswalk for occupational codes. We ranked occupational groups with the incidence of SA being statistically significantly higher than the population average of the country in question and calculated excess fractions with the employee population being the reference group. We observed considerable occupational differences in SA within and between the countries. Few occupational groups had a high incidence in all countries, particularly for mental disorders among men. In each country, manual occupations typically had a high incidence of SA due to any cause and musculoskeletal diseases, while service occupations had a high incidence due to mental disorders. Preventive measures targeted at specific occupational groups have a high potential to reduce work disability, especially due to musculoskeletal diseases. Particularly groups with excess SA in all Nordic countries could be at focus.
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Halonen, Jaana I., Rahman Shiri, Minna Mänty, Hilla Sumanen, Svetlana Solovieva, Eira Viikari-Juntura, Mika Kähönen, Terho Lehtimäki, Olli T. Raitakari, and Tea Lallukka. "Exposure to heavy physical work from early to later adulthood and primary healthcare visits due to musculoskeletal diseases in midlife: a register linked study." BMJ Open 9, no. 8 (August 2019): e031564. http://dx.doi.org/10.1136/bmjopen-2019-031564.
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ObjectivesTo examine whether exposure to heavy physical work from early to later adulthood is associated with primary healthcare visits due to cause-specific musculoskeletal diseases in midlife.DesignProspective cohort study.SettingNationally representative Young Finns Study cohort, Finland.Participants1056 participants of the Young Finns Study cohort.Exposure measurePhysical work exposure was surveyed in early (18–24 years old, 1986 or 1989) and later adulthood (2007 and 2011), and it was categorised as: ‘no exposure’, ‘early exposure only’, ‘later exposure only’ and ‘early and later exposure’.Primary and secondary outcome measuresVisits due to any musculoskeletal disease and separately due to spine disorders, and upper extremity disorders were followed up from national primary healthcare register from the date of the third survey in 2011 until 2014.ResultsPrevalence of any musculoskeletal disease during the follow-up was 20%, that for spine disorders 10% and that for upper extremity disorders 5%. Those with physically heavy work in early adulthood only had an increased risk of any musculoskeletal disease (risk ratio (RR) 1.55, 95% CI 1.05 to 2.28) after adjustment for age, sex, smoking, body mass index, physical activity and parental occupational class. Later exposure only was associated with visits due to any musculoskeletal disease (RR 1.46, 95% CI 1.01 to 2.12) and spine disorders (RR 2.40, 95% CI 1.41 to 4.06). Early and later exposure was associated with all three outcomes: RR 1.99 (95% CI 1.44 to 2.77) for any musculoskeletal disease, RR 2.43 (95% CI 1.42 to 4.14) for spine disorders and RR 3.97 (95% CI 1.86 to 8.46) for upper extremity disorders.ConclusionsTo reduce burden of musculoskeletal diseases, preventive actions to reduce exposure to or mitigate the consequences of physically heavy work throughout the work career are needed.
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Chandra, Gupta Yogesh, and Nathani Neeru. "HEALTH STATUS OF GERIATRIC POPULATION IN RURAL AND URBAN AREAS OF VARANASI - A COMPARATIVE STUDY." February 2021 9, no. 2 (February 21, 2021): 479–84. http://dx.doi.org/10.46607/iamj2509022021.
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The purpose of this study was to assess the health-related problems of rural and urban geriatric population of Varanasi district. A survey-based cross-sectional study was carried out on total 1000 elderly of selected rural and urban areas of Varanasi district by multistage random sampling. Health related details of the re-spondents were gathered through an interview schedule. Most of the respondents were in the age group of 60 to 69 years. The prevalence of hypertension, heart diseases, respiratory diseases, and urinary diseases were significantly higher in rural areas than in urban areas, whereas the prevalence of diabetes mellitus, musculoskeletal problems, and gastrointestinal diseases were significantly higher in urban areas. This study revealed a significant variation in the health status of rural and urban elderly of Varanasi district. People need to be aware of old age and elderly to pay proper attention for better health care to make this later stage of life more pleasant and healthy.
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Moran, Elizabeth B., Mark A. Katz, Orel-Ben Ari, Nadav Davidovitch, and Oren Zwang. "For What Illnesses Do Asylum Seekers and Undocumented Migrant Workers in Israel Seek Healthcare? An Analysis of Medical Visits at a Large Urgent Care Clinic for the Uninsured in Tel Aviv." International Journal of Environmental Research and Public Health 16, no. 2 (January 16, 2019): 252. http://dx.doi.org/10.3390/ijerph16020252.
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In 2017, there were nearly 80,000 asylum seekers and undocumented migrant workers in Israel, most of whom did not have health insurance. We evaluated trends in medical visits of asylum seekers and undocumented migrant workers who presented to Terem Refugee Clinic (TRC), a large clinic in Tel Aviv available only to uninsured residents of Israel. Data were collected from electronic medical records at TRC from 2013–2017. Diagnoses were grouped into categories using ICD-10-equivalent diagnosis codes. We used a chi-squared test for trends to test the significance of trends 2013 to 2017. There were 99,569 medical visits from 2013 to 2017 at TRC. Visits were lowest in 2013 (11,112), and relatively stable from 2014–2017 (range: 19,712–23,172). Most visits were among adults aged 18–35 (41.2%) and children <2 years old (23.7%). Only 3% of visits were from patients aged >50. The percentage of infectious disease diagnoses decreased over the study period, from 9.4% of all diagnoses in adults in 2014 to 5.2% in 2017, and from 32.0% of all diagnoses in children in 2013 to 19.4% in 2017. The annual percentage of respiratory diagnoses in children and adults 18–35 years of age, musculoskeletal in all adults, and digestive in adults except women ≥35 years old increased. Over time, asylum seekers and undocumented migrant workers visited TRC with fewer infectious diseases diagnoses overall but more respiratory diseases, including acute respiratory infections and more musculoskeletal diseases.
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Bouillon, Roger, Leen Antonio, and Oscar Rosero Olarte. "Calcifediol (25OH Vitamin D3) Deficiency: A Risk Factor from Early to Old Age." Nutrients 14, no. 6 (March 10, 2022): 1168. http://dx.doi.org/10.3390/nu14061168.
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Vitamin D deficiency is the main cause of nutritional rickets in children and osteomalacia in adults. There is consensus that nutritional access to vitamin D can be estimated by measuring serum concentrations of 25OHD and vitamin D deficiency can thus be considered as calcifediol deficiency. However, the threshold for vitamin D/calcifediol sufficiency remains a matter of debate. Vitamin D/calcifediol deficiency has been associated with musculoskeletal effects but also multiple adverse extra-skeletal consequences. If these consequences improve or if they can be treated with vitamin D supplementation is still unclear. Observational studies suggest a higher infection risk in people with low calcifediol levels. There is also a consistent association between serum calcifediol and cardiovascular events and deaths, but large-scale, long-term intervention studies did not show any benefit on cardiovascular outcomes from supplementation, at least not in subjects without clear vitamin D deficiency. Cancer risk also did not change with vitamin D treatment, although there are some data that higher serum calcifediol is associated with longer survival in cancer patients. In pregnant women, vitamin D supplementation decreases the risk of pre-eclampsia, gestational diabetes mellitus, and low birth weight. Although preclinical studies showed that the vitamin D endocrine system plays a role in certain neural cells as well as brain structure and function, there is no evidence to support a beneficial effect of vitamin D in neurodegenerative diseases. Vitamin D supplementation may marginally affect overall mortality risk especially in elderly subjects with low serum calcifediol concentrations.
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Немков, A. Nemkov, Афонин, S. Afonin, Антоненков, A. Antonenkov, Калинина, et al. "Occupational Incidence of Employees of Enterprises State Corporation "Rosatom"." Medical Radiology and radiation safety 62, no. 1 (February 26, 2017): 38–43. http://dx.doi.org/10.12737/25052.
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Purpose: To analyze the incidence of occupational diseases of employees of factories and organizations in State Corporation «Rosatom».
Material and methods: The study was conducted with the use of primary documents, containing information about the diseases and working conditions in the workplace. The calculation of this indicator is based on the standard and original software.
Results: In 2014 leading position among professional pathologies adhesive capsulitis of the shoulder (26.1 %), a number enthesopathies (13.4 %), lateral and medial epicondylitis (4.2 % and 0.8 %, respectively) occupy. Pathologies associated with decrease in hearing (9.2 %). Cancers of the respiratory system, as well as malignant neoplasms unspecified localization (5.9 %). In the structure of occupational diseases employees from 50 to 59 years (36.9 %) is dominated; the lowest level of occupational diseases in the group under 39 years (5.9 %). 68.9 % of employees , registered in 2014, were over the age of 50. For the 2010–2014 long-term dynamics of occupational diseases shows its growth from 1.6 cases per 10,000 employees (2010) to 4.5 cases per 10,000 employees (2014). The negative long-term dynamics (2010–2014) observed for occupational diseases of the musculoskeletal system and connective tissue (from 0.1 to 2.57 cases per 10,000 employees), vibration disease (from 0.7 to 0.9 cases per 10,000 employees), malignant neoplasms (from 0.2 to 4.2 cases per 100,000 employees).
Conclusion: During 2010–2014 there was an increase of the incidence, mainly due to professional pathology of the musculoskeletal system and connective tissue, cases of vibration disease and malignant neoplasms. The highest morbidity rate of professional diseases was observed in workers of Priargunsky Industrial Mining and Chemical Union.Analysis of the data showed that the greatest number of diseases was revealed at persons in the age range 50–59 years old.
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Sirén, Maria, Eira Viikari-Juntura, Jari Arokoski, and Svetlana Solovieva. "Work participation and working life expectancy after a disabling shoulder lesion." Occupational and Environmental Medicine 76, no. 6 (March 30, 2019): 363–69. http://dx.doi.org/10.1136/oemed-2018-105647.
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ObjectiveTo examine the impact of a disabling non-traumatic shoulder lesion on work participation and working life expectancy.MethodsFrom a 70% random sample of the Finnish population, we selected 30–59-year-old wage earners with prolonged sickness absence due to a shoulder lesion (n=7644). We followed the persons from 2006 to 2014 and calculated the proportion of time a person spent in different work participation statuses. The associations of potential determinants with a preterm exit from paid employment were tested using Cox regression. Years expected to be spent in different work participation statuses were estimated applying the Sullivan method for healthy life expectancy.ResultsDuring 9 years of follow-up time spent at work was reduced from 77.7% to 46.7%, and 15.8% of the persons were granted disability retirement, mostly due to shoulder and other musculoskeletal diseases. Compared with the general population persons with a disabling shoulder disease are expected to lose from 1.8 to 8.1 years of working life, depending on their age. Age, gender, education, duration of initial sickness absence due to the shoulder lesion, not being able to return to work sustainably and participation in vocational rehabilitation predicted preterm exit from work. Heavy lifting increased the risk of preterm exit marginally.ConclusionsWorking life expectancy is markedly reduced in persons with a disabling shoulder lesion, mainly because of disability retirement due to musculoskeletal problems. Clinicians should consider interventions targeted at improving musculoskeletal functioning and necessary work modifications before shoulder problems become chronic or the persons develop disabling comorbid musculoskeletal conditions.
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Sharashkina, N. V., and N. K. Runikhina. "Preventive technologies in geriatrics: focus on falls." Russian Journal of Geriatric Medicine, no. 2 (August 1, 2021): 196–200. http://dx.doi.org/10.37586/2686-8636-2-2021-186-190.
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Falls predict functional status declines in old age and institutionalization. Among the causes of the falls are sensory deficits, cognitive impairment, chronic diseases such as cardiovascular, endocrine diseases, musculoskeletal system pathology, the use of sedatives, antihypertensive drugs, neuroleptics and diuretics, as well as external causes, including inappropriate aids. The optimal diagnostic method in this case is a comprehensive geriatric assessment, which allows for focused history taking, detailing the circumstances of the fall, identification of risk factors and assessment of consequences, the gait and balance testing, determination of the lower limbs and joints functions are hold in the course of CGA along with orthostatic test that detects sensory deficits. Additional measures of mandatory recommendations should be a discussion of rational nutrition, with an emphasis on adequate intake of protein with food and fluids as prevention.
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Trandafir, A., I. Saulescu, A. Balanescu, D. Opris-Belinski, V. Bojinca, F. Berghea, D. Mazilu, et al. "AB0690 HOW DID COVID-19 AFFECT PATIENTS WITH RHEUMATIC AND MUSCULOSKELETAL DISEASES TREATED WITH DMARDs – EXPERIENCE FROM A ROMANIAN RHEUMATOLOGY HOSPITAL." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 1378. http://dx.doi.org/10.1136/annrheumdis-2021-eular.3092.
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Background:Certainly, the year 2020 changed the healthcare system due to SARS-CoV2 pandemic that affected globally, more than 100 million people, causing more than 2 million of deaths worldwide. The evidence of how this infection impact patients with rheumatic and musculoskeletal diseases treated with disease modifying anti-rheumatic drugs is still an unmet need.Objectives:The main focus of this study is to evaluate the influence of DMARDs therapy on the evolution of COVID-19 disease in patients with RMDs. The second objective is to study and find correlations between the severity of infection in patients with rheumatic diseases.Methods:A retrospective observational study was conducted between June 2020 and January 2021, enrolling 81 patients with rheumatic diseases that went through SARS-CoV2 infection. The data was collected using patients’ clinical documents and through telemedicine, in accordance with EULAR COVID-19 Rheumatological Database.Results:Among the 81 patients, 53 (65,43%) were females and 28 (34,56%) were males. The mean age was 47,9 years old (49,49 years old for females and 45,25 years old for males). The majority lives in urban areas – 62 patients (76,54%).The temporal trends of COVID-19 observed in this cohort was in consonance with the evolution of the pandemic in Romania: one third of cases were recorded between June and October 2020 and two-thirds between November 2020 and January 2021, when the number of COVID-19 cases tripled in the general population.Surprisingly, more than 27% of patients in this study were asymptomatic at the time of COVID-19 diagnosis. They were tested according to the protocol before admission to the hospital. 9,8% of patients also asymptomatic, were tested positive as a screening before leaving the country. The majority (45,6%) were symptomatic or contact with someone infected with SARS-CoV2-and tested positive with RT-PCR.We divided the cohort in 3 groups: patients with mild infection that required no hospitalization (22 patients counting for 27,16%), moderate infection – hospitalization but not in the Intensive Care Unit (52 patients – 64,19%) and severe infection – admission to the ICU/deaths (7 patients in the ICU, 4 deaths – 4,9%).Mild and moderate COVID 19 disease was identified in patients with axial spondyloarthtis (56,7%), with remission or with low disease activity, with a few or no comorbidities, with a mean age of 47,56 years old and also in patients in treatment with MTX (14,86%) or TNF alfa inhibitors (35,13%). 51% of patients stopped the therapy during COVID19 diseases.Factors correlated with severe infection and death were age (the mean age was 62,14), high and moderate disease activity RA, overlap syndromes (RA with SLE or Sjogren Syndrome) and important cardiovascular comorbidities. Two of the deceased patients were in treatment with MTX and RTX (the last infusion was more than 6 months).Conclusion:The data in our study suggests that the use of cs DMARDs (MTX) and TNF alfa inhibitors is associated with better outcomes for patients with RMDs and COVID-19. These results are in accordance with the data found in literature [1,2,3]. The limitation of this study is the little number of patients and the fact that the real number of COVID-19 cases might be higher in reality due to asymptomatic or pauci-symptomatic patients.References:[1]Filière des Maladies Autoimmunes et Autoinflammatoires Rares (FAI2R); Hôpital Huriez, CHU Lille, Univ. Lille, Lille, France, Severity of COVID-19 and survival in patients with rheumatic and inflammatory diseases: data from the French RMD COVID-19 cohort of 694 patients, Annals of the Rheumatic Diseases Published Online First: 02 December 2020[2]Sanchez-Piedra C et al., On behalf of the BIOBADASER study group, et al, Clinical features and outcomes of COVID-19 in patients with rheumatic diseases treated with biological and synthetic targeted therapies,Annals of the Rheumatic Diseases 2020;79:988-990.[3]Hyrich, K.L et al. Rheumatic disease and COVID-19: epidemiology and outcomes. Nat Rev Rheumatol 17, 71–72 (2021)Disclosure of Interests:None declared
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Wang, Lei, Ye Jin, Jingya Zhou, Cheng Pang, Yi Wang, and Shuyang Zhang. "Phenotypic Disease Network-Based Multimorbidity Analysis in Idiopathic Cardiomyopathy Patients with Hospital Discharge Records." Journal of Clinical Medicine 11, no. 23 (November 25, 2022): 6965. http://dx.doi.org/10.3390/jcm11236965.
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Background: Idiopathic cardiomyopathy (ICM) is a rare disease affecting numerous physiological and biomolecular systems with multimorbidity. However, due to the small sample size of uncommon diseases, the whole spectrum of chronic disease co-occurrence, especially in developing nations, has not yet been investigated. To grasp the multimorbidity pattern, we aimed to present a multidimensional model for ICM and differences among age groups. Methods: Hospital discharge records were collected from a rare disease centre of ICM inpatients (n = 1036) over 10 years (2012 to 2021) for this retrospective analysis. One-to-one matched controls were also included. First, by looking at the first three digits of the ICD-10 code, we concentrated on chronic illnesses with a prevalence of more than 1%. The ICM and control inpatients had a total of 71 and 69 chronic illnesses, respectively. Second, to evaluate the multimorbidity pattern in both groups, we built age-specific cosine-index-based multimorbidity networks. Third, the associated rule mining (ARM) assessed the comorbidities with heart failure for ICM, specifically. Results: The comorbidity burden of ICM was 78% larger than that of the controls. All ages were affected by the burden, although those over 50 years old had more intense interactions. Moreover, in terms of disease connectivity, central, hub, and authority diseases were concentrated in the metabolic, musculoskeletal and connective tissue, genitourinary, eye and adnexa, respiratory, and digestive systems. According to the age-specific connection, the impaired coagulation function was required for raising attention (e.g., autoimmune-attacked digestive and musculoskeletal system disorders) in young adult groups (ICM patients aged 20–49 years). For the middle-aged (50–60 years) and older (≥70 years) groups, malignant neoplasm and circulatory issues were the main confrontable problems. Finally, according to the result of ARM, the comorbidities and comorbidity patterns of heart failure include diabetes mellitus and metabolic disorder, sleeping disorder, renal failure, liver, and circulatory diseases. Conclusions: The main cause of the comorbid load is aging. The ICM comorbidities were concentrated in the circulatory, metabolic, musculoskeletal and connective tissue, genitourinary, eye and adnexa, respiratory, and digestive systems. The network-based approach optimizes the integrated care of patients with ICM and advances our understanding of multimorbidity associated with the disease.
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Majnarić, Ljiljana Trtica, Thomas Wittlinger, Dunja Stolnik, František Babič, Zvonimir Bosnić, and Stjepan Rudan. "Prescribing Analgesics to Older People: A Challenge for GPs." International Journal of Environmental Research and Public Health 17, no. 11 (June 5, 2020): 4017. http://dx.doi.org/10.3390/ijerph17114017.
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Background: Due to population aging, there is an increase in the prevalence of chronic diseases, and in particular musculoskeletal diseases. These trends are associated with an increased demand for prescription analgesics and an increased risk of polypharmacy and adverse medication reactions, which constitutes a challenge, especially for general practitioners (GPs), as the providers who are most responsible for the prescription policy. Objectives: To identify patterns of analgesics prescription for older people in the study area and explore associations between a long-term analgesic prescription and comorbidity patterns, as well as the prescription of psychotropic and other common medications in a continuous use. Methods: A retrospective study was conducted in 2015 in eastern Croatia. Patients were GP attenders ≥40 years old (N = 675), who were recruited during their appointments (consecutive patients). They were divided into two groups: those who have been continuously prescribed analgesics (N = 432) and those who have not (N = 243). Data from electronic health records were used to provide information about diagnoses of musculoskeletal and other chronic diseases, as well as prescription rates for analgesics and other medications. Exploratory methods and logistic regression models were used to analyse the data. Results: Analgesics have been continuously prescribed to 64% of the patients, mostly to those in the older age groups (50–79 years) and females, and they were indicated mainly for dorsalgia symptoms and arthrosis. Non-opioid analgesics were most common, with an increasing tendency to prescribe opioid analgesics to older patient groups aged 60–79 years. The study results indicate that there is a high rate of simultaneous prescription of analgesics and psychotropic medications, despite the intention of GPs to avoid prescribing psychotropic medications to patients who use any option with opioid analgesics. In general, receiving prescription analgesics does not exceed the prescription for chronic diseases over the rates that can be found in patients who do not receive prescription analgesics. Conclusion: Based on the analysis of comorbidities and parallel prescribing, the results of this study can improve GPs’ prescription and treatment strategies for musculoskeletal diseases and chronic pain conditions.
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Son, Ju Hyun, Zee Won Seo, Woosik Choi, Youn-Young Lee, Suk-Woong Kang, and Chang-Hyung Lee. "Etiologic Factors of Rotator Cuff Disease in Elderly: Modifiable Factors in Addition to Known Demographic Factors." International Journal of Environmental Research and Public Health 19, no. 6 (March 21, 2022): 3715. http://dx.doi.org/10.3390/ijerph19063715.
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With the aging society, musculoskeletal degenerative diseases are becoming a burden on society, and rotator cuff disease is one of these degenerative diseases. The purpose of this study was to examine the incidence of shoulder osteoarthritis and the etiologic factors of rotator cuff disease in the Korean elderly population. A total of 102 patients performing ultrasonography were recruited, and their demographic factors were analyzed. As functional factors, visual analog scale and the peak torque of external and internal rotators of the shoulder using an isokinetic dynamometer were measured. As an anatomical factor, the acromiohumeral distance in the plain radiograph of the glenohumeral anterior-posterior view was used. There were more female patients (65.7%) than male patients (34.3%). The age range with the highest number of respondents was 50–59 years old. The mean visual analogue score was 4.09 (Min 1 to Max 9). Age and dominant hand side factors appear to be the crucial etiologic factors of the presence and severity of rotator cuff disease. The lower net value of the external rotator strength is weakly related to the presence of rotator cuff disease after adjusting for age, and this is the only modifiable factor in the study.
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Rendžova, Vasilka, Sonja Apostolska, Marina Eftimoska, Biljana Džipunova, and Vesna Filipovska. "Work related muskuloskeletal disorders among dentists at the university dental clinic in Skopje." Stomatoloski glasnik Srbije 65, no. 2 (June 1, 2018): 89–96. http://dx.doi.org/10.2478/sdj-2018-0009.
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Summary Introduction Musculoskeletal disorders (MSDs) are one of the most common types of work-related diseases that affect health workers, especially dentists. The aim of our study was to examine the presence of musculoskeletal disorders among dentists at the university dental clinic in correlation with risk factors. Materials and methods A questionnaire survey was carried out among 78 dental practitioners aged between 20 to 60 years old, employed at the university dental clinic. Questions included data on physical and psychosocial workload, perceived general health and occurrence of musculoskeletal complaints in the past 12 months, chronic complaints, frequency and length of breaks, exercising habits as well as medical care seeking. Results Pain in the back, neck and shoulders (84.6% / 85.9%) was the most common complaint among the majority of respondents, while reduced range of movement was noticed among significantly fewer subjects, mostly between 40-60 years of age. Prolonged statistic position was considered to be one of the main causes of MSDs (82.05%) while 73.08% of respondents stated at least two more reasons beside this one. Conclusion The percentage of MSDs prevalence among dentists in public health sector is high. More extensive surveys should be undertaken to cover larger group of dentists from both private and public sector, in order to obtain complete analysis of the prevalence of occupational disorders in our country.
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Burlutskaya, Alla V., Anastasia V. Statova, and Elena S. Gurina. "THE HEALTH STATUS OF TEENAGERS IN KRASNODAR KRAI." Kuban Scientific Medical Bulletin 26, no. 2 (May 17, 2019): 130–39. http://dx.doi.org/10.25207/1608-6228-2019-26-2-130-139.
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The aim is to assess the health status (morbidity and disability) of adolescents in Krasnodar Krai.Materials and methods. We analysed the offi cial statistical data on the health state of 10– 18 year-old children in Krasnodar Krai during the 2013–2017 period using Form 12 “Information on the number of diseases registered in patients living in the service area of the medical organization” and Form 19 “Information on disabled children”. In addition, the data presented in the report “On medical support of citizens before their initial military registration in Krasnodar Krai in 2017” was analysed.Results. Diseases of the respiratory tract, digestive system, musculoskeletal system and connective tissue, as well as traumas and poisoning, are shown to be leading conditions in the structure of adolescents’ general and primary morbidity. Over the past fi ve years, a decrease in the overall and primary morbidity in 10–14 year-old children has been recorded, although these indicators have shown a growing trend in children aged 15–18 years old. An increase in general and primary disabilities across all age groups in Krasnodar Krai was revealed.Conclusion. An increase in the primary and overall morbidity in 15–18 year-old adolescents, as well as an increase in primary and general disabilities in 10–18 year-old adolescents has been observed. The problem of adolescent health can be solved using an integrated approach. Positive dynamics can only be achieved by oncerted efforts of medical, public and scientifi c organizations.
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Luzina, A. V., N. M. Vorobyeva, N. V. Sharashkina, Yu V. Kotovskaya, N. K. Runikhina, and O. N. Tkacheva. "The influence of geriatric status on labor activity in women aged 55–64 years old." Russian Journal of Geriatric Medicine, no. 4 (January 3, 2021): 305–12. http://dx.doi.org/10.37586/2686-8636-4-2020-305-312.
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Aim: to estimate the associations between employment status, functional and cognitive status, physical health, and geriatric syndromes in women aged 55–64. Materials and methods. A cross-sectional study included 250 women aged 55 to 64 years. Sociodemographic factors, functional and cognitive status, health status, risk factors for chronic noncommunicable diseases (NCD), and presence of NCD were analyzed. The prevalence of changes indicative of geriatric syndromes was estimated. Results. The study included 250 women aged 55–64 years (mean age 59.3 ± 2.9 years). Risk factors (RF) for NCD were identified in all subjects. Abdominal obesity and lipid metabolism disorders (increased blood cholesterol levels and LDL cholesterol levels) were the most common RFs for NCD. The incidence of dyslipidemia as RF NCD was 94%. CVD, diseases of the musculoskeletal system, gastrointestinal tract (GIT), varicose veins of the lower extremities, and endocrine pathology prevailed in NCD. In women aged 55–64 years, aging increases the likelihood that a woman will not work by 2.5 times, using ≥two assistive devices — 2 times, the presence of urinary incontinence/ leakage — 2.3 times, probable depression — 2.7 times. Conclusion: geriatric syndromes are primarily associated with a decrease in functional activity in women aged 55-64 years; this association is associated with socio-demographic, economic factors, and health status (the presence of FRs for NCD and NCD themselves).
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Dalvand, Hamid, Leila Dehghan, Hooshang Dadgar, Saman Maroufizadeh, and Sarvin Sarmadi. "Periodontal Diseases and Dental Caries in Children With Cerebral Palsy." Iranian Rehabilitation Journal 19, no. 3 (September 1, 2021): 289–96. http://dx.doi.org/10.32598/irj.19.3.1410.1.
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Objectives: Musculoskeletal disorders in children with Cerebral Palsy (CP) affect the general health of the mouth and teeth. This study aimed to determine periodontal and dental diseases in children with CP based on gross motor function level, manual ability level, and subtypes of CP. Methods: This research was a cross-sectional study performed on 123 children (3-18 years old) with CP referred to dentistry and rehabilitation centers supervised by Tehran University of Medical Sciences in 2019-2020. They were selected by the convenience sampling method. The children were classified according to the gross motor function classification system: expanded and revised (GMFCS-E&R) for their gross motor function level, according to the manual ability function classification system (MACS) and mini-MACS for the functioning of their hands in handling objects, and according to the quality and topographical pattern of motor impairment for subtypes of CP. The periodontal status of children with CP was evaluated according to the recommendation of the World Health Organization using the community periodontal index and for caries according to the decayed, missing, filled index. All statistical analyses were done by SPSS v. 16. Results: The results showed significant differences between periodontal disease and sex, age, GMFCS-E&R, MACS, mini-MACS levels, and subtypes of CP (P<0.05). But there were no significant differences between teeth diseases and oral motor skills with sex, age, MACS and mini-MACS, GMFCS-E&R levels, and subtypes of CP (P>0.05). Discussion: Periodontal disease and decayed, missing, filled teeth are common problems in CP children, and the conditions worsen with age and level IV and V of GMFCS-E&R and MACS.
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Sugrobova, Galina A., and Yuliia N. Komkova. "Health status and some indices of the day mode of preschool children as predictors of readiness for school learning." Hygiene and sanitation 100, no. 4 (May 18, 2021): 380–86. http://dx.doi.org/10.47470/0016-9900-2021-100-4-380-386.
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Introduction. Low health potential and irrationally organized daily routine of preschool children can be predictors in the structure of causes of violations of cognitive development and behavior of the child. Material and methods. An analysis of the health status of children aged 6 to 7 years old divided by age into three groups: 6-6.5, 6.5-7, and 7-7.5 years. Some indices of the preschool children’s daily routine, including sleeping and walking, were evaluated from the data taken from a questionnaire of parents and teachers. Results. Analysis of the health groups of children aged 6 to 7.5 years old revealed the predominance of group II (48.46%). The number of children who fit into the first health group decreases from 6 to 7.5 years of age. The abnormalities in the musculoskeletal system of the body and ENT diseases, most chronic diseases, prove to be dominated conditions. Boys under seven years of age are significantly more likely to have functional mental disorders and ENT diseases. In general, according to the availability of daytime sleep, the mode of stay of preschoolers differs by 80.0% sleep during the day in kindergarten; 36.3% sleep at home. The length of night sleep in 77.7% of children does not meet the age norms. During the day outside of a preschool educational institution, the outdoor walks are noted in 76.1% of six to seven-and-a-half-year children. The duration of the walk, only in 24.1%, corresponds to the norm. The survey results did not reveal significant differences in the availability of daytime and nighttime sleep in children, depending on age. The number of children who have outdoor walks in their routine daily increases from 6 to 7.5 years of age. The duration of walks is dominated by boys in older age groups. Conclusion. Children’s health potential and daily routine have their own characteristics during the preschool period, which can be considered a risk of developing maladaptation in upcoming systematic training at school.
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Lazko, Olga, Nataliia Byshevets, Vitalii Kashuba, Yuliia Lazakovych, Igor Grygus, Nataliia Andreieva, and Skalski Dariusz. "Prerequisites for the Development of Preventive Measures Against Office Syndrome Among Women of Working Age." Teorìâ ta Metodika Fìzičnogo Vihovannâ 21, no. 3 (September 25, 2021): 227–34. http://dx.doi.org/10.17309/tmfv.2021.3.06.
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The purpose of the article is to study prerequisites for the development of preventive measures against office syndrome among women of working age.
Material and methods. The research involved 52 female office employees 21 to 57 years old.
Results. The extended clustering of the original data using EM method with the performance of V-fold crosschecking has shown that female office employees are clearly divided into two clusters depending on the manifestation of office syndrome. Despite our assumptions, their division does not depend on age or length of service in the office, but on the manifestation of office syndrome and behavioral characteristics in the work process. Women assigned to different clusters are characterized by statistically significant (p < 0.05) differences between the level of pain in the joints and spine. The research has found that among female office employees with increased musculoskeletal pain, there are statistically significantly (p<0.05) more women with significant overweight and spinal diseases. They are less likely to take active breaks when working at a computer and a larger percentage of them use information technology for entertainment purposes outside the office for 3-4 hours a day. However, a smaller percentage of them work with a PC for more than 7 hours a day. Women with predominant musculoskeletal pain differ in their lifestyle and point to fundamentally different reasons that stop them from taking measures to prevent the risk of occupational diseases. In particular, among female office employees with no office syndrome, a statistically significant (p<0.05) larger share does not need to expand knowledge about the organization of health care in the office and among them the share of those who lead a passive lifestyle predominates.
Conclusions. Thus, these women are potentially at risk of developing office syndrome and, with the absence of preventive measures, are expected to move to the cluster of women with signs of office syndrome. The results of the research indicate the need for different approaches to planning health measures in the work environment, depending on the presence of office syndrome and the level of their responsible attitude to health in the work process.
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Moga, Titus David, Ioana Moga, Monica Sabau, Carmen Delia Nistor-Cseppento, Diana Carina Iovanovici, Simona Cavalu, and Bombonica Gabriela Dogaru. "Sarcopenia, a major clinical problem in old age, potential causes, clinical consequences and therapeutic possibilities." Balneo and PRM Research Journal, Vol.13, no.1 (March 19, 2022): 492. http://dx.doi.org/10.12680/balneo.2022.492.
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Sarcopenia or degeneration of skeletal muscle tissue with aging, is responsible for functional de-cline and loss of independence in older adults. The purpose of this article is to review the current definitions of sarcopenia, its potential causes, clinical consequences and the potential for prop-hylactic and curative intervention. Sarcopenia is recognized as a major clinical problem for the elderly, and the research in this area is growing exponentially. One of the most important recent developments has been convergence in the operational definition of sarcopenia that combines muscle mass, strength and muscle function. In 2010, the European Working Group on Sarcopenia in Oder People (EWGSOP) published a definition of sarcopenia aimed at promoting progress in the identification and care of the elderly. In early 2018 (EWGSOP2) he met again to update the original definition to reflect the scientific and clinical evidence that has been built over the past decade. The cause of sarcopenia is considered to be multifactorial: hormonal changes, neurologi-cal decline, sedentary / immobilization for a long period, chronic diseases, obesity, all these fac-tors contribute to the onset of sarcopenia. Prophylactic or curative interventions are essentially aimed at nutrition and exercise. Although pharmaceutical agents are developed that target seve-ral biological pathways, proper nutrition and specific physical exercises remain the gold stan-dard for therapy. Through this review, we want to draw attention to the need to implement complex analyzes of the elderly patient, regardless of the acute problem with which he presents himself at the consultation. These analyses should contain tests, measurements, questionnaires that identify in time a possible musculoskeletal degeneration. The results did not show any sig-nificant difference between the perception of sarcopenia, the way of approaching it and the prophylactic or therapeutic treatment. We focused on this pathology because sarcopenia is rela-tively newly observed, defined, it is not fully investigated and a clinical skill has not been for-med for the evaluation of the elderly patient. Keywords: Skeletal muscle, elderly, sarcopenia, degeneration, exercises
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Santos, Alexandra Ramos dos, Mauro Fernando Kürten Ihlenfeld, Márcia Olandoski, and Fellype Carvalho Barreto. "Comparative analysis of the health status of military police officers and firefighters: a cross-sectional study in the State of Paraná, Brazil." BMJ Open 12, no. 9 (September 2022): e049182. http://dx.doi.org/10.1136/bmjopen-2021-049182.
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ObjectivesTo evaluate the health-condition of military police officers and firefighters. To identify risk factors for not being medically ready for duty.DesignCross-sectional study.SettingData were extracted from medical records during annual periodic health assessments of police officers and firefighters serving with the military police in Paraná, Brazil.Participants6621 police officers (5927 men and 694 women) and 1347 firefighters (1257 men and 90 women) who underwent health assessments between July 2018 and June 2019 were analysed. Pregnant women were excluded.Outcome measuresData included variables such as sex, age, anthropometric measurements, lifestyle, comorbidities and laboratory tests. Multiple logistic regression was used to estimate the probability of not being medically ready for active duty.ResultsOverall, police officers had worse health status than firefighters and greater prevalence of overweight and obesity, regardless of sex. Musculoskeletal diseases were the most commonly reported disease by police officers and firefighters of both sexes. Among men, hypertension was the second most prevalent disease, followed by psychiatric diseases and dyslipidaemia. Among women, psychiatric diseases were the second most prevalent. Male police officers ≥40 years old presented the highest probability of not being considered ready for duty (40.1%). The probability of male police officers between the ages of 31 and 40 not being ready was similar to that for male firefighters >40 years old. There was a higher chance of not being medically ready professionals with diseases such as diabetes mellitus (OR 2.95, 95% CI 1.97 to 5.03), dyslipidaemia (OR 2.65, 95% CI 1.96 to 3.58), hypertension (OR 2.29, 95% CI 1.85 to 4.70), high total cholesterol (OR 2.16, 95% CI 1.93 to 2.42), and heart disease (OR 2.13, 95% CI 1.32 to 3.45).ConclusionsThere was a high prevalence of chronic diseases and modifiable cardiovascular risk factors among police officers and firefighters. Healthy protective measures should be offered frequently, particularly to police officers at an earlier age.
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Averyanova, I. V. "Somatotypological features of men of working age – natives of the North." Acta Biomedica Scientifica 7, no. 2 (May 23, 2022): 105–12. http://dx.doi.org/10.29413/abs.2022-7.2.12.
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Anthropometry is known as the basic method for the body physical status assessment.The aim. The study examined anthropometric and somatometric indices in the working age men and investigated physical development variables specific for the region in terms of being used for early diagnosing obesity-related risks for non-infectious diseases.Materials and methods. One hundred and twenty-three male subjects aged 32–40 participated in the survey (mean age was 35.2 ± 0.2 years). Subjective main physicaldevelopment parameters were analyzed.Results. Participants’ average body length variables were seen to be significantly higher than those in other Russia’s regions and some other countries. The similar tendency was observed for subjective body mass, chest circumference, and body mass index variables with disharmonic somatotype and hypersthenic type of body constitution revealed in examined working age men in comparison with younger male subjects. Musculoskeletal mass loss and fat accumulation indicate the development tendency of sarcopenia in men of working age. Excessive body weight prevalence in 32–40-year-old men was 47 %, and 17 % of the examinees were diagnosed with 1st degree obesity.Conclusion. The survey identified the modern population of male northerners as having negative tendencies in their somatometric picture, which involves disharmonic somatotype, sarcopenia, excessive body weight, and 1st degree obesity and results in significant risks for non-infectious inflammation and cardiovascular diseases at the studied age.
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Liava, C., E. Sinakos, T. Dimitroulas, C. Navrozidou, and E. Akriviadis. "P628 Risk Factors Associated with Extraintestinal Manifestations in Patients with Inflammatory Bowel Diseases." Journal of Crohn's and Colitis 15, Supplement_1 (May 1, 2021): S566. http://dx.doi.org/10.1093/ecco-jcc/jjab076.748.
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Abstract Background Risk factors associated with extraintestinal manifestations (EIMs) in patients with inflammatory bowel disease (IBD) have been evaluated mainly in retrospective studies. We aimed to determine risk factors associated with EIMs and to compare the frequency of EIMs between ulcerative colitis (UC) and Crohn’s disease (CD), based on retrospectively-prospectively collected data of a cohort of IBD patients followed in daily clinical practice. Methods Patients with biopsy-confirmed IBD aged 10–80 years old were included in the study. A comprehensive questionnaire was used to collect data on each site visit from July 2018 until March 2020. Logistic regression analysis and multivariable-adjusted models were used to examine risk factors associated with EIMs and chi-squared test was used to compare the frequency of EIMs between patients with UC and CD. Results 300 patients with IBD (180 with CD, 113 with UC, and 7 with indeterminate colitis) were evaluated. EIMs were observed in 49% of patients, with a 2-fold increased risk in CD (OR 2.31; 95% CI:1.37–3.89; P<.005). The musculoskeletal system was affected in 38% (43% in CD vs 29% in UC, OR 1.86; 95% CI:1.08–3.20; P<.05) with peripheral arthropathy being the most common manifestation (33% in CD vs 23% in UC, P=.095), followed by dermatological manifestations (13%), with a 4-fold increased risk of erythema nodosum in CD (11% vs 3% in UC, OR 3.95; 95% CI:1.12–13.93; P<.05). On univariate logistic regression analysis history of hospitalization for IBD, history of surgery for IBD, aphthous stomatitis, perianal disease, thyroiditis Hashimoto, age, use of thiopurines, and/or anti-TNF in the past were associated with increased risk of developing EIMs. A trend for increased risk of EIMs was found for family history of IBD in first-degree relatives (OR 2.47; 95% CI:0.91–6.74; P=.078) and fecal calprotectin above 250 μg/g (OR 2.22; 95% CI:0.90–5.47; P<.084). On multivariate analysis only aphthous stomatitis (OR 4.60; 95% CI:2.32–9.13; P<.001), perianal disease (OR 2.30; 95% CI:1.17–4.50; P<.05), thyroiditis Hashimoto (OR 2.82; 95% CI:1.03–7.74; P<.05) and age (2% increase in risk per year, OR 1.02; 95% CI:1.01–1.03; P<.05) were significant for EIMs. Conclusion In this retrospective/prospective study 49% of IBD patients developed EIMs with a 2-fold increased risk in CD. Musculoskeletal and dermatological manifestations were the most frequent EIMs. Aphthous stomatitis, perianal disease, thyroiditis Hashimoto and age were associated with increased risk of EIMs.
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Mirabzadeh, Arash, Gita Sadighi, Ahmadali Akbari Kamrani, Mohammadreza Khodaei Ardakani, Golnaz Feyzzadeh, and Mercedeh Samiei. "Comparing Comorbid Profile and the Pattern of Non-Psychiatric Medicine Use Between Elderly and Non-Elderly Patients with Schizophrenia." Iranian Rehabilitation Journal 18, no. 2 (June 1, 2020): 203–10. http://dx.doi.org/10.32598/irj.18.2.962.1.
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Objectives: Patients with schizophrenia receive psychiatric medications for many years, and their comorbid profile in old age remains unclear. Moreover, their pattern of non-psychiatric medicine use is of importance. Rehabilitation is crucial in patients with schizophrenia because it improves their strengths and life skills to live independently. These issues are essential in terms of polypharmacy among them, and its associated adverse effects. Methods: The present cross-sectional study investigated 131 patients with schizophrenia referring to Razi Hospital who were selected by a convenience sampling method. The subjects’ medical records were evaluated in terms of comorbid disorders and non-psychiatric medicine use patterns. Their demographic data were also collected by a separate questionnaire. Results: The frequency of schizophrenia disorder was higher in males aged ≥65 years. The comorbidity frequency of non-psychiatric disorders was significantly higher in the elderly, compared to non-elderly patients. The most prevalent comorbid disorders in the elderly were musculoskeletal, cardiovascular, and metabolic disorders; and in the non-elderly neurological, hematological, and digestive diseases. The prevalence of non-psychiatric medicine intake was significantly higher in the elderly. The prevalence of non-psychiatric medicine use in the elderly (e.g. aspirin, heart disease medications, hypertension medications, etc.) and non-elderly patients (e.g. anemia medications, antibiotics, anticonvulsants, etc.) was not similar. Discussion: In schizophrenic patients, the old age period is associated with more comorbid disorders, compared to their healthy counterparts. Such comorbid profile is similar to other patients; e.g. the most prevalent comorbidities were musculoskeletal, cardiovascular, and metabolic disorders. Polypharmacy is a medical problem in the elderly, with numerous adverse effects. The adjunct consumption of psychiatric medications with the non-psychiatric ones highlights the vital phenomena of drug interactions and associated adverse effects of polypharmacy.
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Moulishree Ramesh, Karthik Ganesh Mohanraj, and Don K R. "Association between osteoarthritis of knee joint with gender, diabetes and work related diseases in middle aged and old aged population - A survey." International Journal of Research in Pharmaceutical Sciences 11, SPL3 (September 9, 2020): 112–22. http://dx.doi.org/10.26452/ijrps.v11ispl3.2900.
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Osteoarthritis is a common musculoskeletal disorder where thinning of cartilage fibers occurs in the joints which causes stiffness, pain, and impairment. Diabetes is a metabolic disorder where the blood sugar level is not maintained properly at normal range. Knee joint osteoarthritis is one of the commonest arthritis. Age is said to be an essential risk factor for diabetes and arthritis. A well-structured set of self-evaluable questionnaires were circulated among the south Indian population. The data was collected by the survey planet link, the questions were verified by the institutional review board and the data was collected and analyzed. The variables were randomized to reduce bias. The data collected were manipulated and statistically analyzed. The awareness level and the suggestions regarding the relation between age, gender, diabetes, and knee joint arthritis were questioned and the opinions discussed. It was found that about 61.9% of the population suffers from osteoarthritic conditions. 46.4% of the population are sure and 43.3% population somewhat believe that onset of osteoarthritis is due to their diabetic condition. About 25.8% sure and 34% somewhat agree with the other risk factors of osteoarthritis. 43.3% of the population strongly agrees, 23.7% agree that obesity is a risk factor for both diabetes and osteoarthritis. About 47.4% of the populations are sure about the association between osteoarthritis and diabetes. The response shows that there is a relation between osteoarthritis and diabetes. So further studies should be made over the relation between diabetes and knee joint osteoarthritis among the middle and old aged population and the mechanism behind it and spread awareness about the same.
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Nuibe, Andrew, Beenish Rubbab, and Rebecca E. Levorson. "478. Contemporaneous Evaluation of Kawasaki Disease and Multi-system Inflammatory Syndrome in Children in Northern Virginia." Open Forum Infectious Diseases 8, Supplement_1 (November 1, 2021): S341. http://dx.doi.org/10.1093/ofid/ofab466.677.
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Abstract Background Multi-system inflammatory syndrome in children (MIS-C) can present like Kawasaki disease (KD). After Centers for Disease Control and Prevention guidance was issued in May 2020, we implemented local management strategies emphasizing limited laboratory work up of non-toxic children with suspected MIS-C or KD. We then re-evaluated our management recommendations to ensure appropriate resource utilization for children with MIS-C and KD. Methods We identified MIS-C and KD cases via convenience sampling of Pediatric Infectious Diseases records at Inova Fairfax Medical Center from May 1, 2020 to February 28, 2021. Manual chart review extracted clinical points of interest and descriptive statistics compared cohorts. Oral changes included edema, erythema, cracking, or strawberry tongue. Abdominal symptoms included pain, emesis, and diarrhea. Respiratory symptoms included shortness of breath, tachypnea, cough, and need for mechanical ventilation. Musculoskeletal symptoms included pain and edema. Neurological symptoms included headache, dizziness, altered mental status, and irritability. Results We identified 8 KD cases and 29 concurrent MIS-C cases. MIS-C cases tended to be older and have presenting abdominal symptoms (median age 8 years old versus 2 years old, p < 0.01) and hypotension (20 versus 0, p < 0.01), otherwise there was no difference in the frequency of oral changes, rash, conjunctivitis, musculoskeletal symptoms, or neurological symptoms. 7 KD cases and 8 MIS-C cases did not require intensive care. Patients with MIS-C who did not need intensive care still had a lower initial absolute lymphocyte count (ALC) (median 1275/µL, p < 0.01), lower initial platelet count (median 217/µL, p = 0.05), and higher initial C-reactive protein (CRP) (median 18.3 mg/dL, p = 0.06) compared to KD cases; other results were not different between the two cohorts. Conclusion We observed differences in the initial ALC, platelet count, and CRP between KD and MIS-C cases not requiring intensive care, whereas other labs such as ferritin, troponin, B-natriuretic peptide, and initial echocardiograms did not significantly differ between the two cohorts. Thus, our diagnostic management recommending limited laboratory evaluation for non-toxic patients with suspected KD or MIS-C is reasonable. Disclosures All Authors: No reported disclosures
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Aminova, Olga S., N. N. Tyatenkova, Yu E. Uvarova, and S. V. Yakovlev. "MONITORING HEALTH INDICES IN FEMALES OF DIFFERENT AGE GROUPS." Hygiene and sanitation 98, no. 8 (October 28, 2019): 827–32. http://dx.doi.org/10.18821/0016-9900-2019-98-8-827-832.
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Introduction. Health - is a complex and at the same integral multivariable dynamic state, developing in the process of realization of the genetic potential in a particular social and ecological environment, which permits a person to carry out its biological and social functions. Material and methods Health indices deteriorate with age. In this situation, special attention should be paid to older age groups. However, recent studies prefer to investigate young people. Data about health status of different age groups is not well investigated. Survey of 415 women aged 20 to 59 years residing on Yaroslavl region has been performed. Evaluation of age-related changes in health indices included questionnaire, morphological and functional examination, definition of physical development and adaptative potential according to the calculated indices and reference values. Results. The study examined the dynamics of health indices and established a statistically significant difference in the gain in body weight, blood pressure, total blood cholesterol, decreased lung capacity relative to body mass and adaptive capacity of the cardiovascular system with the age. Analysis of the incidence showed that chronic diseases incidence has increased from 56% in the 20-29 years group to 88% among 50-59 years old persons. Diseases of cardiovascular and musculoskeletal system (48-49%) become predominant pathology with age. Evaluation of lifestyle shows that poor physical activity and sleep disorders were registered in 77% and 32% respectively regardless of age. Eating disorders were registered in 41% patients aged of 20-29 years. Ratio tobacco users decreased from 23% to 10% with age, while the number of cigarettes smoked per day was increased. Сonclusion. The study established the negative dynamics of health indices to be typical for women aged 20-59 years, while the rate of deterioration exceeds the average one in the Russian population. Self-preservation behavior is not predominant in all age groups, it is typical only for 3% of young women and 11-15% of other groups.
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Marengoni, Alessandra, Roselyne Akugizibwe, Davide L. Vetrano, Albert Roso-Llorach, Graziano Onder, Anna-Karin Welmer, and Amaia Calderón-Larrañaga. "Patterns of multimorbidity and risk of disability in community-dwelling older persons." Aging Clinical and Experimental Research 33, no. 2 (February 2021): 457–62. http://dx.doi.org/10.1007/s40520-020-01773-z.
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AbstractThe aim was to analyze the association between specific patterns of multimorbidity and risk of disability in older persons. Data were gathered from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K); 2066 60 + year-old participants living in the community and free from disability at baseline were grouped according to their multimorbidity patterns and followed-up for six years. The association between multimorbidity patterns and disability in basic (ADL) and instrumental (IADL) activities of daily living was examined through multinomial models. Throughout the follow-up, 434 (21.0%) participants developed at least one ADL and 310 (15.0%) at least one IADL. Compared to the unspecific pattern, which included diseases not exceeding their expected prevalence in the total sample, belonging to the cardiovascular/anemia/dementia, the sensory impairment/cancer and the musculoskeletal/respiratory/gastrointestinal patterns was associated with a higher risk of developing both ADL and IADL, whereas subjects in the metabolic/sleep disorders pattern showed a higher risk of developing only IADL. Multimorbidity patterns are differentially associated with incident disability, which is important for the design of future prevention strategies aimed at delaying functional impairment in old age, and for a better healthcare resource planning.
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Babaeva, T. N., V. N. Sibirtseva, A. V. Yudanov, L. A. Shpagina, K. V. Khalzov, Y. Yu Shebunyaeva, S. P. Melekhov, and T. I. Pospelova. "Hemophilia in the city of Novosibirsk and Novosibirsk region: Clinical phenotype, comorbidity." Russian journal of hematology and transfusiology 66, no. 3 (October 25, 2021): 374–85. http://dx.doi.org/10.35754/0234-5730-2021-66-3-374-385.
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Introduction. Despite the success of current therapeutic approaches and suffi cient supply of clotting factor concentrates, adult patients with hemophilia have a high frequency of developing joint pathologies. Furthermore, an increase in life expectancy has correlated with an increase in the share of patients with concomitant somatic diseases, which are characteristic for this population over the age of 40 years.Aim — to analyze the treatment results of adults with hemophilia living in the city of Novosibirsk and Novosibirsk region and evaluate their orthopedic status, types, frequency of bleeding, and comorbidity structure.Material and methods. A total of 93 patients were enrolled in the study (including 86 patients with hemophilia A and seven patents with hemophilia B). The analysis was carried out separately in subgroups of patients according to age: 18–24, 25–34, 45–44, and over 45 years old. Hemophilia type, severity of disease, strategy of therapy, inhibitor status, and features of concomitant pathology were analyzed.Results. A high frequency of spontaneous bleeding was found in all age groups of patients enrolled in the study (39.6 and 34.9 % during 6 and 12 months, respectively). The average frequency of joint bleeding was 4 cases per person per year in the group of patients aged ≥ 18 years.In evaluation of orthopedic status, it was remarkable that there was a signifi cant number of target joints (262, n = 93), which amounted to 2.8 defected joints per patient (the elbow, knee, and ankle joints were the most frequently involved in pathological process). All patients aged over 18 years with severe and moderate form of disease had a musculoskeletal complication with involvement of one or more target joints.The number of diseases per one patient prevailed in the age group over 45 years old and amounted to 4.12 comorbidities per patient. The prevalent diseases in the structure of concomitant pathology in adult patients with hemophilia were chronic viral hepatitis C (43.1 %, n = 42), stage I–III arterial hypertension (27.9 %, n = 26), stomach and duodenum diseases as well as gallbladder pathology (33.3 %, n = 31 and 26.9 %, n = 25, respectively), urolithiasis and chronic secondary pyelonephritis (21.5 %, n = 20).Conclusion. Despite the use of clotting factor concentrates in patients with severe and moderate hemophilia, the frequency of joint hemorrhages remains high, regardless of the age prophylactic replacement therapy was started. Additional measures must be taken to prevent the appearance of critical disease phenotype with frequent spontaneous bleeding.
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Mihăilă, Delia, Raluca Maria Iordache, and Viorica Petreanu. "Dorsopathy in urban public transport drivers in relation to occupational risks and workloads." MATEC Web of Conferences 342 (2021): 01018. http://dx.doi.org/10.1051/matecconf/202134201018.
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Drivers in urban public transport are exposed to specific risks and workloads with both somatic and psychological effects on their health. The most common somatic disorders are musculoskeletal diseases (MSDs), especially those of the spine, and some of them can be occupational diseases. The present paper represents a sequence from an ample study that has followed the effects of this professional activity on work aptitude and workers’ state of health and then has established prevention measures, respectively measures for reduction of identified risk factors. An ergonomic, complex and multidimensional methodology has been used. The health state analysis has been performed through a prevalence, cross-sectional study on three cohorts (bus, tram, trolleybus drivers). In all groups, a high percentage of spinal pathology has been found, especially lumbosacral. The highest percentage of dorsopathies has been registered in the group of the trolleybus drivers (48%), followed by the tram (43%) and the bus (42%). In all three cohorts, a significant percentage in disc herniation in the age group 36-45 years old has been found, which can indicate premature wear. The identification of occupational risk factors has allowed for the establishment of a set of prevention / reduction measures.
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Marędziak, Monika, Agnieszka Śmieszek, Klaudia Chrząstek, Katarzyna Basinska, and Krzysztof Marycz. "Physical Activity Increases the Total Number of Bone-Marrow-Derived Mesenchymal Stem Cells, Enhances Their Osteogenic Potential, and Inhibits Their Adipogenic Properties." Stem Cells International 2015 (2015): 1–11. http://dx.doi.org/10.1155/2015/379093.
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Aging and sedentary lifestyle are common nowadays and are associated with the increasing number of chronic diseases. Thus, physical activity is recommended as one of three healthy behavior factors that play a crucial role in health prophylaxis. In the present study, we were interested whether physical activity influences the number and potential of bone-marrow-derived mesenchymal stem cells BMMSCs. In this study, four-week-old male C57Bl/6 mice were trained on a treadmill at progressive speeds over a 5-week period. Comparisons made between exercised (EX) and sedentary animal groups revealed (i) significantly higher number of MSCs in EX animals, (ii) elevated alkaline phosphatase (ALP) activity, (iii) increased level of osteopontin (OPN) and osteocalcin (OCL), and (iv) reduced marrow cavity fat. The results obtained support the thesis that EX may play a substantial role in the regeneration of mesenchymal tissues. Therefore, EX may represent a novel, nonpharmacological strategy of slowing down age-related decline of the musculoskeletal functions.
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Maguire, Brian J., Linda M. Hughes, Douglas C. McAdams, Michael Gilbert, and Robert Nordness. "Health conditions among Navy divers at end of service: a retrospective cohort study." Undersea and Hyperbaric Medicine 49, no. 2 (January 1, 2022): 13–28. http://dx.doi.org/10.22462/01.02.2022.2.
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Purpose: To identify the most prevalent health conditions among divers during their last year of Navy service. Methods: For this retrospective descriptive study we used data from the Dive Jump Reporting System to identify 4,623 active-duty divers who separated between 2008 and 2018. Medical records, dive histories, and personnel files were merged, linked and analyzed at the individual level. Results: On average, 420 divers separated each year. Among the separating divers, 99% were male, 26% were aged 25 to 29 years old with a mean age of 35 (SD = 9, range 18 to 65). The major medical categories with the highest numbers of divers affected were: musculoskeletal system diseases (prevalence rate (PR) = 515.2 per 1,000 divers/year); nervous system (PR = 411.9); injury and poisonings (PR = 249.8); and mental disorders (PR = 237.3). Of the 50 specific conditions that affected the most divers the top four were joint disorders (PR = 34.5), disorders of refraction and accommodation (PR = 30.1), back disorders (PR = 26.8) and organic sleep disorders (PR = 21.6). Compared to divers with fewer than 29 dives, divers with 49-plus dives were about twice as likely to have diagnoses related to symptoms involving head and neck. Conclusions: The study found high rates of conditions such as musculoskeletal disorders, joint and back disorders, and some mental health related disorders. Special warfare divers have high rates of hearing loss, and other disorders of ear. The results show the need and to develop and implement group-specific mitigation programs.
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Popov, V. V., I. A. Novikova, and M. V. Trokhova. "Features of multimorbidity in elderly and senile people with hypertension." Russian Journal of Cardiology 26, no. 4 (May 22, 2021): 3940. http://dx.doi.org/10.15829/1560-4071-2021-3940.
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Aim. To reveal the features of multimorbidity in elderly and senile people with hypertension (HTN).Material and methods. A total of 70 elderly and senile hypertensive patients were examined at one of the Arkhangelsk outpatient clinics (from 60 to 90 years old; mean age — 69,14±1,34 years), including those aged 60-74 years (n=56; (80,0%) and 75 years and older (n=14; 20,0%). We assessed the questionnaire survey data, the outpatient medical records, the clinical status, and the cumulative illness rating scale for geriatrics (CIRS-G).Results. The analysis showed a high prevalence of multimorbidity in elderly and senile people with HTN, which was found in all patients. On average, an elderly patient with HTN has 6 diseases that are pathogenetically interrelated and unrelated, while a senile patient has 8 diseases. The most common comorbidities were gastrointestinal (81,43%), musculoskeletal (77,14%) and endocrine (77,14%) diseases. Among the cardiovascular comorbidities in the elderly with HTN, the following were more common: heart failure (54,29%), coronary artery disease (angina pectoris — 41,43%) and cerebrovascular diseases (28,57%) (stroke/transient ischemic attack, vascular encephalopathy). Patients with HTN took an average of 6 different drugs at the same time. There was moderate comorbidity level in the elderly patients and a high one in those of senile age.Conclusion. In elderly and senile patients with HTN, there is a high prevalence of multimorbidity, which must be taken into account when preventing polypharmacy.
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Kim, Jeong-Kyun, Myung-Nam Bae, Kangbok Lee, Jae-Chul Kim, and Sang Gi Hong. "Explainable Artificial Intelligence and Wearable Sensor-Based Gait Analysis to Identify Patients with Osteopenia and Sarcopenia in Daily Life." Biosensors 12, no. 3 (March 7, 2022): 167. http://dx.doi.org/10.3390/bios12030167.
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Osteopenia and sarcopenia can cause various senile diseases and are key factors related to the quality of life in old age. There is need for portable tools and methods that can analyze osteopenia and sarcopenia risks during daily life, rather than requiring a specialized hospital setting. Gait is a suitable indicator of musculoskeletal diseases; therefore, we analyzed the gait signal obtained from an inertial-sensor-based wearable gait device as a tool to manage bone loss and muscle loss in daily life. To analyze the inertial-sensor-based gait, the inertial signal was classified into seven gait phases, and descriptive statistical parameters were obtained for each gait phase. Subsequently, explainable artificial intelligence was utilized to analyze the contribution and importance of descriptive statistical parameters on osteopenia and sarcopenia. It was found that XGBoost yielded a high accuracy of 88.69% for osteopenia, whereas the random forest approach showed a high accuracy of 93.75% for sarcopenia. Transfer learning with a ResNet backbone exhibited appropriate performance but showed lower accuracy than the descriptive statistical parameter-based identification result. The proposed gait analysis method confirmed high classification accuracy and the statistical significance of gait factors that can be used for osteopenia and sarcopenia management.
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Chaiamnuay, Sumapa. "Assessment and Treatment of Postmenopausal Osteoporosis: An Appraisal of International Guidelines." Journal of Clinical Rheumatology and Immunology 22, Supp01 (June 2022): 31–39. http://dx.doi.org/10.1142/s2661341722300051.
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Recently, several updates in the assessment and treatment of postmenopausal osteoporosis guidelines were published. This review discusses international guidelines, including the algorithm for management of patients at risk of osteoporotic fracture from the International Osteoporosis Foundation (IOF) and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) 2020, The Pharmacological Management of Osteoporosis in Postmenopausal Women: An Endocrine Society Clinical Practice Guideline (2019)/Guideline Update (2020), and the American Association of Clinical Endocrinologists (AACE)/American College of Endocrinology (ACE) guidelines for the diagnosis and treatment of postmenopausal osteoporosis-2020 update. Due to the recent COVID-19 pandemics, the joint guidance on osteoporosis management in the era of COVID-19 pandemic will also be included. The criterion for diagnosis of osteoporosis has been published by AACE/ACE. All postmenopausal women of age ≥50 years old should be evaluated for osteoporosis risk. Those at very high risk for fracture are recommended to start treatment with anabolic agents and those at high risk for fracture are recommended to start treatment with antiresorptive agent such as bisphosphonates or denosumab. Intervention thresholds and treatment options vary from country to country. Physicians should individualize the treatment according to risks, benefits, patient preferences, as well as treatment accessibility.
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Salugina, S. O., E. S. Fedorov, M. I. Kaleda, E. A. Kamenets, and E. Y. Zakharova. "CLINICAL AND GENETIC CHARACTERISTICS OF PATIENTS WITH TUMOR NECROSIS FACTOR RECEPTOR-ASSOCIATED PERIODIC SYNDROME (TRAPS) ACCORDING TO THE DATA FROM THE V.A. NASONOVA RESEARCH INSTITUTE OF RHEUMATOLOGY." Pediatria. Journal named after G.N. Speransky 101, no. 4 (August 19, 2022): 64–71. http://dx.doi.org/10.24110/0031-403x-2022-101-4-64-71.
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The tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is a rare autosomal dominant disease associated with a mutation in the TNFRSF1A gene. It belongs to the group of monogenic autoinflammatory diseases (mAIDs) characterized by the repeated and prolonged episodes of fever, skin rashes, musculoskeletal, ophthalmic symptoms and an increase in the level of acute phase markers. The main targeted therapy is inhibitors of interleukin-1 (IL-1). The purpose of the study was to present the clinical and genetic characteristics of patients with TRAPS according to the data from the V.A. Nasonova Research Institute of Rheumatology (Moscow, Russia). The study included 28 patients from 2013 till 2021 with a clinical diagnosis of TRAPS from a selection of 162 (both pediatric and adult) patients with mAIDs: 17 females/11 males aged 2.5 to 65 years old (Me 9.0 y/o [7.9; 14.5]); 7 adults/21 children. All of them have underwent molecular genetic analysis for mutations in the TNFRSF1A gene. Results: the TRAPS was diagnosed in 28 (17.3%) among 162 patients with mAIDs. The age of onset ranged from 1 month till 28 years old (Me 4.0 y/o [1.0; 7.1]). Most patients fell ill prior to the age of 10 years old (89.3%), of which 8 (28.6%) before 1 year old, 7 (25%) from 1 to 5 years old, 1 (3.6%) from 5 to 10 years old, 10 (35.7%) from 10 to 18 years old and 2 (7.1%) from 21 to 28 years old. The duration of the disease and the delay in diagnosis at the time of inclusion ranged from 3 months till 59 years old. The diagnosis was made within the first year of illness in 4 (14.3%) of observed cases; within 1 to 10 years in 18 (64.3%); in 8 (28.6%) there was a delay in diagnosis of over 10 years; and in 4 (14.3%) the delay was more than 20 years of illness. The duration of attacks varied from 10 to 30 days, the intervals between the attacks ranged from 2 weeks till 6 months. The clinical manifestations were as follows: fever in 96.4% of cases, skin rashes in 71.4%, musculoskeletal symptoms in 18 (64.3%) cases, oligoarthritis in 9 (32.1%), polyarthritis in 2 (7.1% ), gastrointestinal manifestations in 18 (64.3%), lymphadenopathy of various groups in 10 (35.7%), ophthalmological manifestations in 8 (28.6%). The less often were the different nervous system manifestations, which accounted for 6% to 21% of cases, pharyngitis in 4 (14.3%) and stomatitis in 2 (7.1%). An increase in the sedimentation rate of erythrocytes was noted in 23 (82.1%), C-reactive protein in 20 (71.4%), leukocytosis in 11 (39.3%). The diagnosis in all patients was confirmed genetically. 10 patients had a low-penetrance mutation of р.Arg121Gln (р.Arg92Gln according to the old nomenclature). 5 familial cases were identified, the total number of sick family members was 12, from 2 to 4 in each family; 4 cases of amyloidosis (the all four were adults). Treatment: glucocorticoids in 19 (67.9%) cases, Cyclosporine A in 1, Colchicine in 5. 15 patients (53.6%) received genetically engineered biological preparations, the IL-1 (Canakinumab) was prescribed in 10 (35.7%) patients with the duration of admission from 1 to 9 years, Etanercept in 1, Adalimumab in 1 and Tocilizumab in 3. Conclusion: due to the similarity of clinical and laboratory symptoms with manifestations of rheumatic diseases, patients with TRAPS can be encountered in the rheumatologists’ practice. Most patients in the studied cohort had an early onset of the disease (prior to 10 years old), and the diagnosis delay of 10+ years was noted in 1/3 of patients. All patients had a specialized inflammatory phenotype coupled with genetic mutations. About half had required the appointment of biological drugs, IL-1 mainly. A complete response to the therapy in most patients and a good tolerability of treatment were noted, which allows the authors to consider this as the basis in the treatment and management of patients with TRAPS.
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Vadakedom, Suresh S., Deepa K. Krishnan, Darly Saramma Mammen, Bindhu K. P., and Jiji Mary Antony. "Medical problems in children with Down syndrome." International Journal of Advances in Medicine 5, no. 5 (September 22, 2018): 1290. http://dx.doi.org/10.18203/2349-3933.ijam20183910.
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Background: Down syndrome (DS) is a major cause of mental retardation of prenatal origin and has several associated co-morbidities involving cardiovascular system, respiratory, endocrine system, hematological, gastrointestinal, musculoskeletal, eye and ear defects, immunological changes and neurological system. This study was conducted to identify the common medical problems in children with Down syndrome and the morbidity associated with these conditions. The objective of the present study was to find out the occurrence of different medical problems in children with DS.Methods: 42 children with a phenotype of Down syndrome in the age group of 0-12 years attending the outpatient, inpatient and Down syndrome Clinic of the Institute of Child Health, Kottayam during the study period were included in the study by purposive sampling. Demographic details were entered, and Pediatric Clinical Examination was performed by the investigator himself to identify the medical problems. Old medical reports were reviewed, and data entered into a proforma and statistically analysed.Results: Out of the 42 children with DS, 22 were males. 15 (35.7%) were less than 1 year, 20 (48.3%) children 1-5 years and 7 (16.1%) children 5-12 years of age. Mean age of the study group was 1.78±0.51 years. Mean age of their mothers at the time of conception was 30.6±5.8 years. 26 (57%) children with Down syndrome had a medical problem during the neonatal period which required hospitalization. Almost all systems are affected and craniofacial features, developmental delay and hypotonia were universal. Various forms of congenital heart diseases were observed in 67% and hypothyroidism in 23.8%.Conclusions: Down syndrome is a common genetic disorder with multisystem involvement. Congenital heart diseases, hypothyroidism and recurrent respiratory infections were the common medical problems identified in this study.
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Valvanne, Jaakko, Kati Juva, Timo Erkinjuntti, and Reijo Tilvis. "Major Depression in the Elderly: A Population Study in Helsinki." International Psychogeriatrics 8, no. 3 (September 1996): 437–43. http://dx.doi.org/10.1017/s1041610296002797.
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The aim of the study was to estimate the prevalence of major depression and to evaluate associated features in random age cohorts of 75, 80, and 85 years (N = 651). A clinical examination was made by experienced health center physicians, and major depression was diagnosed according to DSM-III criteria. The prevalence increased with age and was 1% to 4% in the age groups of 75 and 80 years, but 13% at the age of 85 years. No sex difference was found. The frequency of major depression was fourfold among institutionalized patients (16%) as compared to those living at home (4%). Major depression was strongly associated with objective health, intellectual functioning, and functional capacity. Depression was most common in subjects suffering from poor vision, urinary incontinence, or Parkinson's disease (odd ratios 4.2 to 4.9). Depression was also correlated with musculoskeletal disorders, coronary heart disease, and cerebrovascular diseases (odd ratios 2.5 to 3.4). The survey suggests that major depression is quite rare in healthy elderly people but common in disabled institutionalized patients.
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Khramtsov, Petr I., Anna S. Sedova, and Nadezhda O. Berezina. "Improving the criteria for a comprehensive assessment of the foot condition during preventive medical examinations of children and adolescents." Russian Pediatric Journal 23, no. 4 (August 6, 2020): 259–64. http://dx.doi.org/10.18821/1560-9561-2020-23-4-259-264.
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Introduction. According to the results of in-depth medical examinations of students of different age groups, the leading ranks in the structure of functional abnormalities and chronic diseases belong to disorders and diseases of the musculoskeletal system (MSS), including disorders of the formation of the foot. The purpose of the study is to improve the methodological support for a comprehensive assessment of the foot condition during preventive medical examinations of children and adolescents. Materials and methods. The study involved 222 children 7-10 years old and 330 children and adolescents 11-18 years old. The assessment of the foot condition was based on the visual research method and the plantography method using the Bauerfiend plantograph (Germany). The condition of the longitudinal arch of the foot was assessed using the Shtriter method, and the transverse arch was assessed using the foot width index. We used an Express method for evaluating the position of the forefoot and a method for visualizing the footprint to identify options for distributing the support load on the plantar surface of the foot. Results. A method of the comprehensive assessment of the foot condition in students aged 7-18 years based on visual and instrumental research methods has been developed. The criteria values of indices for evaluating the longitudinal and transverse arches of the foot are justified. The normal longitudinal arch of the foot is set at the value of the Streeter index - 36-50% for children aged 7-10 years and 40-53% - for teenagers of 11-18 years. The normal state of the transverse arch of the foot corresponded to the values of the foot width index in the range of 37-40% for children 7-10 years old and 36-39% for adolescents 11-18 years old. Conclusion. The presented algorithm of foot examination and criteria for a comprehensive assessment of its condition can be used for mass preventive medical examinations of children and adolescents to improve the accuracy of diagnostics and increase their effectiveness.
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Khan, Taimoor Akram, Anam Farooq, Amna Farooq, Muhammad Nasir, Gohar Khan, and Ali Akram Khan. "Demographic and Disease Patterns at a Primary Healthcare Setting." Annals of King Edward Medical University 24, no. 1 (March 31, 2018): 695–700. http://dx.doi.org/10.21649/akemu.v24i1.2323.
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The assessment of disease pattern and burden in a defined population based on the symptomatology as well as the organic presentation is quite fruitful.Objectives: This study was designed to determine demographic characteristics and disease patterns related to different organ systems presenting at first tier of primary healthcare system. Methods: A cross-sectional study was conducted using Basic Health Unit’s (BHU) Outdoor Patient Department (OPD) database retrospectively in order to determine the age, gender and organ system wise distribution of various diseases. Secondary data was collected from standard OPD register in which all patients that presented in the outpatient department of the facility during a period of 6 months from 1st January, 2017 to 30th June, 2017 were included and no patient was excluded. Results: Out of total 2357 patients, 1024 (43.4%) were males and 1333 (56.6%) were females. Most of the patients 1057 (44.8%) belonged to the age group of 15-49 years whereas only 96 (4.1%) were less than one year old. About 2204 patients (93.5%) presented for the first time to the BHU and 153 patients (6.5%) were follow-up patients. Majority of patients 735 (31.2%) presented with symptoms of respiratory system. Certainsystems were more involved in females than males like musculoskeletal system (257 v/s 113), respiratory system (377 v/s 358) and especially the genitourinary system (50 v/s 5). Conclusions: Addressing and treating the diseases presenting at this basic level (BHU) can prove to be very useful in reducing patient load at the level of tertiary care and teaching hospitals.
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Larasati, Adinda Nadira, and Elman Boy. "The Impact of Physical Activity in Elderly." MAGNA MEDICA: Berkala Ilmiah Kedokteran dan Kesehatan 6, no. 2 (December 13, 2020): 113. http://dx.doi.org/10.26714/magnamed.6.2.2019.113-121.
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Physical activity has been identified as a protective factor for non-communicable diseases such as cardiovascular disease, stroke, diabetes, some types of cancer and has been linked to slowing the onset of dementia, improved mental health, and improved quality of life and well-being. The increase in the number of the elderly population causes the need for special attention to the elderly, so that in addition to having a long life, the elderly can also enjoy their old age happily. Special attention is needed on promotional measures to support the elderly to participate in physical activity to help overcome the decline in functional capacity associated with aging. This literature review aims to provide an understanding of the impact of physical activity on the elderly. Elderly who do physical activity will get many positive effects, ranging from increasing bone density, reducing fat accumulation, increasing body mass index, reducing the risk of damage to the musculoskeletal system, reducing the risk for the development of cardiovascular disease, cancer, other chronic diseases, as hypertension management because it can lower blood pressure. Physical activity also greatly affects the increase in dopamine levels and changes in neutrophic factors that have neuroprotective functions so that they can inhibit cognitive decline and dementia, and BDNF as a neutrophic factor can help the elderly prevent symptoms of depression or anxiety.
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Alpizar-Rodriguez, D., F. Irazoque-Palazuelos, T. S. Rodriguez-Reyne, E. Zamora, D. X. Xibille Friedmann, A. Castillo Ortiz, M. U. Martínez-Martínez, et al. "POS1242 FACTORS ASSOCIATED WITH MORTALITY IN PATIENTS WITH RHEUMATIC DISEASES AND COVID-19 IN MEXICO." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 904.1–904. http://dx.doi.org/10.1136/annrheumdis-2021-eular.3342.
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Background:As of the 25th of January 2021, more than 150 thousand deaths as consequence of COVID-19 have been reported in Mexico [1]. Advanced age, male gender and comorbidities have been described as risk factors for severe disease and mortality in general population [2]. COVID-19 mortality in Mexican patients with rheumatic and musculoskeletal diseases (RMDs) is unknown.Objectives:To describe characteristics of Mexican patients with RMDs and COVID-19, and to analyse factors associated with mortality.Methods:The Global Rheumatology Alliance COVID-19 (GRA) physician reported registry, is an international effort to collect information on COVID19 in adult patients with RMDs. GRA is an observational registry. The first patient from Mexico was registered on April 17, 2020. All Mexican patients registered in GRA until October 30, 2020 were included in this analysis. The association of mortality with demographic and clinical variables was estimated using logistic regression analysis.Results:A total of 323 patients were registered, with a median age of 52 (IQR 41-61) years old, 166 (51.4%) patients lived in Mexico City. The most frequent RMDs were rheumatoid arthritis, 149 (46.1%) and systemic lupus erythematosus, 24 (19.8%). Over a third of patients with RMDs and COVID-19 (119 (36.8%)) were hospitalized, and 43 (13.3%) died. Table 1 shows clinical and demographic characteristics. In the univariable analysis, the absence of comorbidities was a protective factor, OR 0.3 (95% CI 0.1-0.6). Factors associated with mortality at COVID-19 diagnosis were age over 65 years old, having type 2 diabetes, chronic renal insufficiency, treatment at COVID-19 diagnosis with corticosteroids or with CD20 inhibitors. In the multivariable adjusted analysis, these factors remained independently associated with mortality. No associations with other treatments or comorbidities at COVID-19 diagnosis were found.Conclusion:Mexican patients with RMDs and COVID-19 in the GRA physician reported registry had a mortality of 13.3%. Factors associated with mortality were those described in the general population, such as older age and being on corticosteroids and CD20 inhibitors treatment at COVID-19 diagnosis.References:[1]WHO. Coronavirus disease (COVID-19) pandemic. https://www.who.int/emergencies/diseases/novel-coronavirus-2019. (accessed 26 January, 2021).[2]Zhou F, et al. Lancet 2020;395(10229):1054-62.Table 1.Clinical and demographic characteristics of patients with rheumatic diseases and COVID-19 in Mexico and mortality.Characteristics at COVID-19 diagnosisTotalN=323Death43 (13.3)Survivors280 (86.7)UnivariableOR (95% CI)MultivariableOR (95% CI)Women, n(%)268 (82.9)33 (76.7)235 (83.9)0.6 (0.3-1.4)0.5 (0.2-1.3)Age >65 years old, n(%)62 (19.2)18 (41.9)44 (15.7)3.9 (1.9-7.7)3.9 (1.9-8.3)RMDs* n(%)-Rheumatoid arthritis149 (46.1)23 (53.5)126 (45.0)1.6 (0.7-3.7)-Systemic Lupus Erythemathosus64 (19.8)10 (23.3)54 (19.3)1.6 (0.6-4.3)-Spondyloarthritis (axial and others)33 (10.2)2 (4.7)31 (11.1)0.1 (0.1-2.8)-Others77 (23.8)8 (18.6)69 (24.6)1-Moderate/High disease activity1, n(%)57 (18.6)7 (17.9)50 (18.7)1.0 (0.4-2.5)-None comorbidities, n(%)136 (42.1)8 (18.6)128 (45.7)0.3 (0.1-0.6)-Hypertension*, n(%)88 (27.2)12 (27.9)76 (27.1)1.0 (0.5-2.1)-Type 2 Diabetes*, n(%)49 (15.2)13 (30.2)36 (12.9)2.9 (1.4-6.1)2.4 (1.1-5.4)Obesity*, n(%)21 (6.5)3 (6.9)18 (6.4)1.1 (0.3-3.9)-Chronic obstructive pulmonary disease*, n(%)15 (4.6)1 (2.3)14 (5.0)0.5 (0.1-3.5)-Chronic renal insufficiency*, n(%)17 (5.2)6 (13.9)11 (3.9)3.9 (1.4-11.4)3.4 (1.1-10.4)Cardiovascular diseases*, n(%)14 (4.3)2 (4.7)12 (4.3)1.1 (0.2-5.0)-Corticosteroids*, n(%)171 (52.9)30 (69.7)141 (50.3)2.3 (1.1-4.5)3.0 (1.4-6.5)CsDMARD*, n(%)247 (76.5)33 (16.3)214 (76.4)1.0 (0.5- 2.2)-CD20 inhibitor*, n(%)21 (6.5)7 (16.3)14 (5.0)3.7 (1.4-9.9)4.9 (1.7-14.5)*Overlapped, 1 307 patients.Disclosure of Interests:None declared
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Chernikova, Ekaterina F. "Occupational risk and early signs of disadaptation in young traffic police officers working in a shift schedule." Russian Journal of Occupational Health and Industrial Ecology 60, no. 11 (December 3, 2020): 884–87. http://dx.doi.org/10.31089/1026-9428-2020-60-11-884-887.
Full textAbstract:
Introduction. In the course of their professional activities, traffic police inspectors of State Road Safety Inspectorate (SRSI) are exposed to harmful working conditions. The aim of study is to provide scientific justification for the periods of service of inspectors that are important for the diagnosis of early signs of professionally caused diseases. Materials and methods. The study was carried out in a group of traffic police inspectors of the traffic police in accordance with the ethical standards set forth in the Declaration of Helsinki, 1975 (with additions, 1983), a positive conclusion of the ethical committee. The age of the traffic police officers was 24-50 years old, the experience was 1-19 years (average values 34±0.46 and 8.21±0.40 years). Results. In the course of the study, a class of working conditions was determined-3.4. low-level traffic police officers showed signs of disadaptation, a high risk of morbidity with temporary disability and professionally caused pathology of the cardiovascular, musculoskeletal, nervous, endocrine, and digestive systems. Conclusions. It is advisable to conduct an in-depth preventive medical examination of inspectors after 1-2 years of service. The first 4 years of service are important for preventive measures.