The burden of low back pain in Brazil : estimates from the Global Burden of Disease 2017 Study

Background: The prevalence and burden of musculoskeletal (MSK) conditions are growing around the world, and low back pain (LBP) is the most significant of the five defined MSK disorders in the Global Burden of Disease (GBD) study. LBP has been the leading cause of non-fatal health loss for the last three decades. The objective of this study is to describe the current status and trends of the burden due to LBP in Brazil based on information drawn from the GBD 2017 study. Methods: We estimated prevalence and years lived with disability (YLDs) for LBP by Brazilian federative units, sex, age group, and age-standardized between 1990 and 2017 and conducted a decomposition analysis of changes in age- and sex-specific YLD rates attributable to total population growth and population ageing for the purpose of understanding the drivers of changes in LBP YLDs rates in Brazil. Furthermore, we analyzed the changes in disability-adjusted life years (DALYs) rankings for this disease over the period. Results: The results show high prevalence and burden of LBP in Brazil. LBP prevalence increased 26.83% (95% UI 23.08 to 30.41) from 1990 to 2017. This MSK condition represents the most important cause of YLDs in Brazil, where the increase in burden is mainly related to increase in population size and ageing. The LBP age-standardized YLDs rate are similar among Brazilian federative units. LBP ranks in the top three causes of DALYs in Brazil, even though it does not contribute to mortality. Conclusions: Findings from this study show LBP to be the most important cause of YLDs and the 3rd leading cause of DALYs in Brazil. The Brazilian population is ageing, and the country has been experiencing a rapid epidemiological transition, which generates an increasing number of people who need chronic care. In this scenario, more attention should be paid to the burden of non-fatal health conditions.Telemedicin

Luxação acromioclavicular tipo V: comparação entre dois métodos de tratamento cirúrgico

Objetivo: Comparar os resultados clínicos e radiográficos do tratamento cirúrgico da luxação acromioclavicular tipo V, utilizando dois métodos: âncoras em conjunto com fio de Kirschner ou parafuso de Bosworth. Métodos: Foram avaliados vinte pacientes entre 19 e 60 anos de idade (média: 33,3 anos) e acompanhamento entre 6 e 36 meses (média de 17,4 meses). Fixação coracoclavicular com ancoragem no processo coracóide e fios de Kirschner realizados em dez casos, os demais foram fixados por parafuso conforme descrito por Bosworth. A avaliação incluiu os escores de Constant, UCLA e ASES, satisfação pessoal e avaliação radiográfica. Resultados: Os tipos de tratamento alcançaram redução adequada e satisfação pessoal na maioria dos casos. O Grupo 2 apresentou escores Constant (91,0) e ASES (94,8) maiores do que os do Grupo 1 (89,0) e (94,6), respectivamente. A osteoartrite da articulação acromioclavicular ocorreu apenas no Grupo 1 (50%) p=0,0325. Nenhuma das técnicas apresentou complicações graves, observou-se infecção superficial no Grupo 1 (20%) e soltura do parafuso no Grupo 2 (10%). Conclusão: Apesar da maior taxa de infecção e osteoartrite da articulação acromioclavicular nas técnicas com fio e âncoras de Kirschner, não houve diferença estatística nos resultados clínicos, radiográficos e funcionais em comparação com as técnicas de parafuso de Bosworth

The burden of low back pain in Brazil : estimates from the Global Burden of Disease 2017 Study

Background: The prevalence and burden of musculoskeletal (MSK) conditions are growing around the world, and low back pain (LBP) is the most significant of the five defined MSK disorders in the Global Burden of Disease (GBD) study. LBP has been the leading cause of non-fatal health loss for the last three decades. The objective of this study is to describe the current status and trends of the burden due to LBP in Brazil based on information drawn from the GBD 2017 study. Methods: We estimated prevalence and years lived with disability (YLDs) for LBP by Brazilian federative units, sex, age group, and age-standardized between 1990 and 2017 and conducted a decomposition analysis of changes in age- and sex-specific YLD rates attributable to total population growth and population ageing for the purpose of understanding the drivers of changes in LBP YLDs rates in Brazil. Furthermore, we analyzed the changes in disability-adjusted life years (DALYs) rankings for this disease over the period. Results: The results show high prevalence and burden of LBP in Brazil. LBP prevalence increased 26.83% (95% UI 23.08 to 30.41) from 1990 to 2017. This MSK condition represents the most important cause of YLDs in Brazil, where the increase in burden is mainly related to increase in population size and ageing. The LBP age-standardized YLDs rate are similar among Brazilian federative units. LBP ranks in the top three causes of DALYs in Brazil, even though it does not contribute to mortality. Conclusions: Findings from this study show LBP to be the most important cause of YLDs and the 3rd leading cause of DALYs in Brazil. The Brazilian population is ageing, and the country has been experiencing a rapid epidemiological transition, which generates an increasing number of people who need chronic care. In this scenario, more attention should be paid to the burden of non-fatal health conditions.Telemedicin