RESUMO
Se presenta en las imágenes una artritis psoriásica grave y deformante. Aproximadamente el 5 por ciento de las personas con artritis psoriásica tienen este tipo de artritis. La artritis psoriásica mutilante por lo general afecta las manos y los pies. También puede causar dolor en el cuello...(AU)
Assuntos
Masculino , Feminino , Artrite Psoriásica/epidemiologia , Artropatias/epidemiologiaRESUMO
RESUMEN Introducción: Los trabajadores de la salud se enfrentan permanentemente a labores complejas que afectan la región lumbar y miembros inferiores. Objetivo: Identificar la prevalencia de enfermedad osteomioarticular lumbosacras y miembros inferiores en auxiliares de enfermería Método: Se realizó un estudio epidemiológico, descriptivo y transversal en una muestra de 46 auxiliares del Distrito 18D04 de salud de Tungurahua, Ecuador. El instrumento aplicado fue un cuestionario para indagar variables sociodemográficas, antigüedad en el sector, horarios, tipos y tiempo de exposición a las labores habituales. Se utilizó la prueba estadística Chi-cuadrado, la paramétrica de correlación de Pearson y la prueba t de Student. Resultados: El 85 % de los estudiados presentó enfermedades lumbosacras y miembros inferiores durante el tiempo de trabajo, se apreció que el 39 % ha tenido una baja temporal al trabajo entre 1-3 días. Se identificó que la carga de peso es realizada por un 37 % y caminatas prolongadas en un 33 %. El 67 % tenía entre 11 y 40 años de trabajo y el resto menos de 10 años en el sector. El 54 % padeció enfermedades pertenecientes a miembros inferiores y un 46 % a lumbosacras. Conclusiones: El padecimiento de enfermedad osteomioarticular lumbosacras y miembros inferiores está relacionado con la edad y con padecerlas en los últimos doce meses, estas han provocado ausentismo laboral. No se comprobó una relación estadísticamente significativa con el padecimiento de enfermedad osteomioarticular con la antigüedad en el sector, las jornadas de trabajo y las actividades que más desarrollan.
ABSTRACT Introduction: Health care workers are constantly confronted with complex tasks that affect the lumbar region and lower limbs. Objective: To identify the prevalence of lumbosacral and lower limb osteomyoarticular pathologies in nursing assistants. Method: An epidemiological, descriptive and cross-sectional study was carried out in the 18D04 health district of Tungurahua, Ecuador. A total of 46 nursing assistants were selected in this study. We aimed a questionnaire to assess the sociodemographic variables, seniority in the health sector, time schedules, modes and time of exposure to the usual work. Chi-square test, Pearson's parametric correlation test, and the Student's t-test were used. Results: Most nursing assistants, the 85%, were diagnosed with lumbosacral and lower limb pathologies, and 39% took a temporary absence from work between 1-3 days. It was found that 37 % performed the heavy load work and 33% performed prolonged walks. The 67% had between 11 and 40 years of work and the rest had less than 10 years in the health sector. Fifty-four percent suffered from lower limb pathologies and 46% from lumbosacral pathologies. Conclusions: Lumbosacral and lower limb osteomyoarticular pathology is related to age, and their suffering in the last 12 months has led to a level of absenteeism in the workplace. There was no an important relationship, statistically, between osteomyoarticular pathology and seniority in the sector, working hours and the activities most frequently performed.
RESUMO Introdução: Os trabalhadores da saúde enfrentam constantemente tarefas complexas que afetam a região lombar e membros inferiores. Objetivo: Identificar a prevalência de doenças osteomioarticulares lombossacrais e de membros inferiores em auxiliares de enfermagem. Método: Estudo epidemiológico, descritivo e transversal em uma amostra de 46 auxiliares do Distrito Sanitário 18D04 de Tungurahua, Equador. O instrumento aplicado foi um questionário para investigar variáveis sociodemográficas, antiguidade no setor, horário, tipos e tempo de exposição a tarefas normais. Foram utilizados o teste estatístico Qui-quadrado, correlação paramétrica de Pearson e teste t de Student. Resultados: 85% dos estudados apresentaram doenças lombossacrais e de membros inferiores durante o tempo de trabalho, observou-se que 39% tiveram afastamento temporário do trabalho entre 1-3 dias. Identificou-se que a descarga de peso é realizada por 37% e as caminhadas prolongadas por 33%. 67% tinham entre 11 e 40 anos de trabalho e o restante menos de 10 anos no setor. 54% sofreram doenças pertencentes aos membros inferiores e 46% lombossacral. Conclusões: O sofrimento da doença osteomioarticular lombossacral e de membros inferiores está relacionado à idade e com o sofrimento nos últimos doze meses, estes têm causado absenteísmo ao trabalho. Não foi verificada relação estatisticamente significativa entre o sofrimento de doença osteomioarticular e o tempo de permanência no setor, a jornada de trabalho e as atividades que mais desenvolvem.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Doenças Ósseas/epidemiologia , Dor Lombar/epidemiologia , Extremidade Inferior , Artropatias/epidemiologia , Doenças Musculares/epidemiologia , Assistentes de Enfermagem , Esgotamento Profissional , Epidemiologia Descritiva , Estudos TransversaisRESUMO
INTRODUCTION: One of the most common complications of the surgical treatment of breast cancer is limited range-of-motion in the shoulder. Scapular winging is one of the most underdiagnosed shoulder mobility impairments. OBJECTIVE: The main objective of this study was to determine the incidence of scapular winging in patients who underwent breast cancer surgery as the basis for expanding the protocol to patients who have had a sentinel lymph node biopsy. The secondary objective was to determine the risk factors that lead to the development of a winged scapula presented after breast cancer treatment in our sample. METHODS: This was a prospective, observational, and multidisciplinary study. Between 2013 and 2018, 214 consecutive patients who had been diagnosed with breast cancer and treated for it surgically were followed by Rehabilitation Department for 3 years. The patients were evaluated in the 1st, 6th, 12th, 18th, 24th and 36th months following surgery. Scapular winging was evaluated at each visit by means of static and dynamic tests. RESULTS: The cumulative incidence of scapular winging was 3.6% and seven cases of winged scapula were diagnosed. All the cases were diagnosed at the first visit, 1 month after the intervention. In the univariate analysis, the axillary lymph node dissection technique was a more significant risk factor for a winged scapula than sentinel lymph node biopsy. CONCLUSIONS: The axillary lymph node dissection technique is a risk factor for developing a winged scapula. No evidence was found for any other significant risk factor.
Assuntos
Neoplasias da Mama/cirurgia , Artropatias/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Escápula , Biópsia de Linfonodo Sentinela/efeitos adversos , Articulação do Ombro , Assistência ao Convalescente , Análise de Variância , Feminino , Seguimentos , Humanos , Incidência , Artropatias/etiologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Amplitude de Movimento Articular , Fatores de Risco , Biópsia de Linfonodo Sentinela/métodosRESUMO
The joint disease called pararamosis is an occupational disease caused by accidental contact with bristles of the caterpillar Premolis semirufa. The chronic inflammatory process narrows the joint space and causes alterations in bone structure and cartilage degeneration, leading to joint stiffness. Aiming to determine the bristle components that could be responsible for this peculiar envenomation, in this work we have examined the toxin composition of the caterpillar bristles extract and compared it with the differentially expressed genes (DEGs) in synovial biopsies of patients affected with rheumatoid arthritis (RA) and osteoarthritis (OA). Among the proteins identified, 129 presented an average of 63% homology with human proteins and shared important conserved domains. Among the human homologous proteins, we identified seven DEGs upregulated in synovial biopsies from RA or OA patients using meta-analysis. This approach allowed us to suggest possible toxins from the pararama bristles that could be responsible for starting the joint disease observed in pararamosis. Moreover, the study of pararamosis, in turn, may lead to the discovery of specific pharmacological targets related to the early stages of articular diseases.
Assuntos
Artrite Reumatoide/epidemiologia , Artropatias/epidemiologia , Lepidópteros/patogenicidade , Osteoartrite/epidemiologia , Toxinas Biológicas/toxicidade , Animais , Artrite Reumatoide/induzido quimicamente , Humanos , Inflamação/induzido quimicamente , Inflamação/epidemiologia , Artropatias/induzido quimicamente , Artropatias/patologia , Lepidópteros/química , Doenças Profissionais/induzido quimicamente , Doenças Profissionais/epidemiologia , Osteoartrite/induzido quimicamente , Membrana Sinovial/efeitos dos fármacos , Membrana Sinovial/patologia , Toxinas Biológicas/isolamento & purificação , Peçonhas/efeitos adversos , Peçonhas/químicaRESUMO
Since the first evidence of human parvovirus B19 (B19V) infection in late 80s, several studies have been conducted to clarify the spectrum of clinical diseases in Brazil. B19V infection is prevalent in the general population and has exhibited a cyclical pattern of occurrence every 4-5 years, with the predominance of genotype 1 over 3b. During epidemic periods the wide range of clinical conditions, such as ertythema infectiosum, arthropathy, transient aplastic crisis, nonimmune hydrops fetalis and B19V-hepatitis were diagnosed. However, many infections are likely asymptomatic or have a self-limiting clinical course and are not readly diagnosed. Besides, the similarity of the symptoms of ertythema infectiosum to other rash diseases and the broadly circulation of arboviruses makes differential diagnosis more difficult. In this article, we provide a historical comprehensive overview of the research on parvovirus B19 conducted in Brazil, with a focus on the clinical and epidemiological aspects of the infection.
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Infecções por Parvoviridae/virologia , Parvovirus B19 Humano/fisiologia , Brasil/epidemiologia , Doenças Hematológicas/diagnóstico , Doenças Hematológicas/epidemiologia , Doenças Hematológicas/virologia , Humanos , Artropatias/diagnóstico , Artropatias/epidemiologia , Artropatias/virologia , Infecções por Parvoviridae/diagnóstico , Infecções por Parvoviridae/epidemiologia , Parvovirus B19 Humano/classificação , Parvovirus B19 Humano/genética , Parvovirus B19 Humano/isolamento & purificaçãoRESUMO
INTRODUCTION: Extraintestinal manifestations (EIMs) are frequent in patients with inflammatory bowel disease (IBD). Our objective is to characterize and determine the prevalence of MEIs in our cohort of patients with IBD. PATIENTS AND METHODS: A retrospective study was carried out in adult patients with IBD at the Pablo Tobón Uribe Hospital in Medellín. Colombia. Articular MEIs, primary sclerosing cholangitis (PSC), both ophthalmological and dermatological, were considered. Absolute and relative frequencies were used. The Chi square test of independence was used to compare 2proportions and the odds ratio (OR) was estimated. RESULTS: Our registry has 759 patients with IBD, 544 present UC (71.6%), 200 CD (26.3%) and 15 unclassifiable IBD (1.9%); 177 patients with IBD (23.3%) presented EIMs, 123 of 544 (22.6%) with UC and 53 of 200 (26.5%) with CD (OR: 0.81, 95% CI: 0.55-1.17, P=0.31). Regarding the type of EIMs, the articular ones were the most frequent (13.5%), more in CD than in UC (20.0 vs. 11.3%, OR 1.94, 95% CI: 1.25-3.00, P=0.0037). Patients with IBD and EIMs used more antibodies against tumor necrosis factor (anti-TNFs), compared to those without EIMs (43.5 vs. 18.5%, OR 3.38, 95% CI: 2.31-4.90, P=0.0001). CONCLUSIONS: The prevalence of EIMs in our cohort is high (23.3%) and the most frequent type is joint. Anti-TNFs are most used when IBD and EIMs coexist. Our study provides valuable information on the association of EIMs and IBD in Latin America.
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Doenças Inflamatórias Intestinais/complicações , Distribuição de Qui-Quadrado , Estudos de Coortes , Colite Ulcerativa/complicações , Colite Ulcerativa/epidemiologia , Colômbia/epidemiologia , Doença de Crohn/complicações , Doença de Crohn/epidemiologia , Eritema Nodoso/epidemiologia , Eritema Nodoso/etiologia , Feminino , Humanos , Doenças Inflamatórias Intestinais/epidemiologia , Artropatias/epidemiologia , Artropatias/etiologia , Masculino , Razão de Chances , Úlceras Orais/epidemiologia , Úlceras Orais/etiologia , Prevalência , Psoríase/epidemiologia , Psoríase/etiologia , Pioderma Gangrenoso/epidemiologia , Pioderma Gangrenoso/etiologia , Estudos Retrospectivos , Esclerite/epidemiologia , Uveíte/epidemiologia , Uveíte/etiologiaRESUMO
BACKGROUND: Total joint arthroplasty has historically been very successful for most patients, yet some still incur a complication. In an era of value-based care, certain efforts need to be taken to optimize patients' risk profile before surgery to decrease the chances of readmission or surgical complication. METHODS: We reviewed 10 key medical conditions and lifestyle factors that surgeons should improve before pursuing total joint arthroplasty and provide a summary of the available literature to guide certain optimization thresholds. RESULTS: With careful attention to and the creation of a preoperative checklist, surgeons can identify key domains, including morbid obesity, malnutrition, diabetes, smoking, opioid use, poor dentition, cardiovascular disease, preoperative anemia, staphylococcus colonization, and psychological disorders and intervene based on an individual's areas of deficiencies. CONCLUSION: By following stringent protocols and rescheduling surgery until optimization has occurred, we can work to provide patients the best chance for a successful outcome with an elective hip or knee arthroplasty.
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Artroplastia de Quadril , Artroplastia do Joelho , Artropatias/epidemiologia , Idoso , Artroplastia de Quadril/efeitos adversos , Artroplastia de Quadril/estatística & dados numéricos , Artroplastia do Joelho/efeitos adversos , Artroplastia do Joelho/estatística & dados numéricos , Comorbidade , Procedimentos Cirúrgicos Eletivos , Feminino , Humanos , Artropatias/cirurgia , Masculino , Pessoa de Meia-Idade , Readmissão do Paciente/estatística & dados numéricos , Fatores de Risco , Resultado do Tratamento , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: Musculoskeletal disorders (MSD) are an occupational health problem that demands a high cost and may also reduce the quality of life and productivity of the dentists. The aim of this study was to evaluate the prevalence of MSD and its association with self-reported joint damage in dentists from São Paulo (Brazil). METHODS: This was a cross-sectional study performed from two self-administered questionnaires - the Nordic Musculoskeletal Questionnaire and the other containing demographic and occupational data - in 6072 dentists. Between April and May 2014, 5885 questionnaires were distributed via e-mail through São Paulo Regional Board of Dentistry (CRO-SP) and 187 in Congress and public offices. Multivariable logistic regression was used to assess the association between explanatory variables (sex, age, level of education, duration of practice in years, number of patients seen per day, previous receipt of information about ergonomics, physical activity, and the presence of joint damage) and MSD. RESULTS: Two hundred eighty-six valid questionnaires were returned. The prevalence of MSD was 63.6% (N.=182). Multivariable logistic regression showed that only the factor of self-reported joint damage has a significant association with MSD (OR 0.001; 95% CI: 0.000-0.007). Concerning the self-reported joint damage (60.1%), the carpal tunnel syndrome was the most frequent (13.2%). CONCLUSIONS: The prevalence of MSD in dentists from São Paulo is high, and carpal tunnel syndrome is the most common self-reported joint damage.
Assuntos
Odontologia , Odontólogos , Artropatias/etiologia , Doenças Musculoesqueléticas/etiologia , Doenças Profissionais/etiologia , Adulto , Brasil/epidemiologia , Síndrome do Túnel Carpal/epidemiologia , Síndrome do Túnel Carpal/etiologia , Estudos Transversais , Feminino , Humanos , Artropatias/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/epidemiologia , Doenças Profissionais/epidemiologia , Prevalência , Prática Profissional/estatística & dados numéricos , Autorrelato , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: To assess IgM anti-alpha-enolase antibodies (AAEA) in systemic Behçet's disease (BD) and its possible association with clinical manifestations and disease activity. METHODS: Ninety-seven consecutively selected BD patients were compared to 36 enteropathic spondyloarthritis (ESpA) [24 Crohn's disease (CD) and 12 ulcerative colitis (UC)] patients and 87 healthy controls. IgM AAEA was detected by immunoblotting. Disease activity was assessed by standardised indexes, Brazilian BD Current Activity Form (BR-BDCAF) for BD and Harvey-Bradshaw Index (HBI) for CD and UC patients. A second evaluation was performed in BD patients (n=56), regarding IgM AAEA presence, disease activity scores and C-reactive protein (CRP). RESULTS: Higher IgM AAEA prevalence was found in 97 BD (17.7%) compared to ESpA (2.8%) and healthy controls (2.3%), p<0.001. IgM AAEA frequency was higher in active BD compared to inactive BD (30.2% vs. 7.4%, p=0.006), a finding confirmed in the second cross-sectional evaluation of 56 of these BD patients (45.5% vs. 13.3%, p=0.02). Mean BR-BDCAF scores were higher in IgM AAEA positive group on both evaluations (9.1 ± 5.4 vs. 4.9 ± 4.9, p=0.002; 5.0 ± 4.9 vs. 2.2 ± 2.9, p=0.01, respectively). BD patients with mucocutaneous and articular symptoms presented higher IgM AAEA positivity in the first and second evaluations (64.7% vs. 27.5%, p=0.005; 36.4% vs. 7.1%, p=0.039 respectively). CONCLUSIONS: Our data support the notion that alpha-enolase is a target antigen in BD, particularly associated with disease activity, mucocutaneous and articular involvement. In addition, IgM AAEA may distinguish BD from ESpA, especially in patients with high disease activity.
Assuntos
Autoanticorpos/imunologia , Síndrome de Behçet/imunologia , Biomarcadores Tumorais/imunologia , Proteínas de Ligação a DNA/imunologia , Imunoglobulina M/imunologia , Artropatias/imunologia , Fosfopiruvato Hidratase/imunologia , Proteínas Supressoras de Tumor/imunologia , Adulto , Autoanticorpos/sangue , Síndrome de Behçet/sangue , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/epidemiologia , Biomarcadores/sangue , Brasil/epidemiologia , Estudos de Casos e Controles , Estudos Transversais , Progressão da Doença , Feminino , Humanos , Imunoglobulina M/sangue , Artropatias/sangue , Artropatias/diagnóstico , Artropatias/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Índice de Gravidade de DoençaRESUMO
OBJECTIVE: To analyze factors associated with chronic joint symptoms (CJS) in adults. METHOD: A population-based, cross-sectional study was performed with a sample of 1,217 adults aged between 20 and 59 years, in the city of Viçosa, in 2014. The sampling process was performed by conglomerates and sample was selected using a two-stage cluster-sampling scheme. First, 30 of the 99 census tracts of Viçosa were randomly selected using a random sampling scheme, without replacement. Household questionnaires were applied to obtain CJS data, sociodemographic conditions, behavioral factors and health status. Multivariable analysis was conducted using Poisson regression, adjusted for the sampling design effect, using the svy commands in Stata software. RESULTS: Prevalence of CJS totaled 31.27%, significantly higher in women (18.45). Age ranges 40-49 (PR 1.50; 95CI 1.16-1.92) and 50-59 years (PR 1.55; 95CI 1.07-2.25); overweight (PR 1.60; 95CI 1.28-2.00); obesity (PR 1.60; 95CI 1.11-2.29); and those who self-reported performing heavy work (PR 1.27; 95CI 1.09-1.48) showed higher prevalences of CJS. CONCLUSION: Women and individuals who were older, overweight and performing heavy work had a higher risk of CJS in this adult population residing in Viçosa, MG, Brazil.