Reported morbidities and quality of life: population-based study

O objetivo deste trabalho foi verificar o nível de qualidade de vida relacionada à saúde (QVRS) em uma amostra de base populacional de adultos de 20 anos ou mais, residentes na cidade de Bauru, São Paulo, e sua associação com a quantidade de morbidades referidas. Foi realizado um inquérito populacional, por meio de uma amostragem complexa em dois estágios, totalizando 600 participantes da zona urbana de Bauru. Para a coleta de dados foram utilizados os seguintes instrumentos: 1. caracterização dos participantes (aspectos demográficos, socioeconômicos, nível de atividade física e hábito de fumar); 2. morbidade (referida por meio da pergunta: "No último ano, o (a) sr. (a) recebeu diagnóstico médico de alguma doença?"); 3. qualidade de vida (utilizando o questionário Medical Outcomes Study 36 - Item Short-Form Health Survey - SF-36). Foram realizadas análises descritiva e bivariada, por meio do teste t de Student e ANOVA. Observou-se que 70,5% apresentaram pelo menos uma doença, e as principais referidas foram a hipertensão, as artroses, a depressão e o diabetes. Quanto à associação entre os números de doenças, as pessoas mais idosas e as que referiram três ou mais doenças apresentaram piores escores de QVRS em todos os domínios físicos e nas limitações por aspectos sociais e emocionais. O maior número de morbidades associou-se aos menores escores de qualidade de vida relacionada à saúde.The purpose was to verify the level of health-related quality of life in a population-based sample of adults aged 20 years or more living in the city of Bauru, São Paulo, Brazil, and its association with the amount of reported morbidities. A population survey was conducted through a complex sampling in two stages, totaling 600 participants in the urban area of Bauru, São Paulo. To collect data, the following instruments were used: 1. Characterization of participants (demographic and socio-economic aspects, physical activity level and smoking habit); 2. reported morbidity through the following question: "Last year, did you receive a diagnosis of any illness from a doctor?; 3. Quality of Life, using the Medical Outcomes Study 36 - Item Short-Form Health Survey (SF-36) questionnaire. Descriptive and bivariate analyses were carried out using the Student's t-test and ANOVA. It was noted that 70.5% had at least one disease, and the most common morbidities reported were hypertension, osteoarthritis, depression, and diabetes. The association between the number of diseases, those who reported three or more diseases, and older age had worse HRQOL scores in all physical domains and limitations by social and emotional aspects. A greater number of comorbidities was associated with the lower scores of health-related quality of life.El objetivo de este estudio fue verificar el nivel de calidad de vida relacionada a la salud (QVRS) en una muestra de base poblacional de adultos de 20 años o más, residentes de la ciudad de Bauru, São Paulo, y su asociación con la cantidad de morbilidades referidas. Se realizó una encuesta poblacional mediante una muestra compleja en dos estadios, con un total de 600 participantes de la zona urbana de Bauru. Para la recolección de datos se utilizó los siguientes instrumentos: 1. caracterización de los participantes (aspectos demográficos, socioeconómicos, nivel de actividad física y hábito de fumar); 2. morbilidades (referida mediante la pregunta: "En el último año, usted ha recibido el diagnóstico médico de alguna enfermedad?"); 3. calidad de vida (utilizando el cuestionario Medical Outcomes Study 36 - Item Short-Form Health Survey - SF-36). Se realizó análisis descriptivos y bivariados, mediante la prueba T de Student y Anova. Se observó que 70,5% presentaron por lo menos una enfermedad, y las principales referidas fueron la hipertensión, la artrosis, la depresión y la diabetes. En relación a la asociación entre los números de enfermedades, las personas mayores y las que refirieron tres o más enfermedades presentaron peores scores de QVRS en todos los dominios físicos y en las limitaciones por aspectos sociales y emocionales. El mayor número de morbilidades se asoció a los menores scores de calidad de vida relacionada a la salud

Morfologia cerebral, desempenho funcional e características clínicas de pacientes com migrânea - um estudo transversal

Objective: To investigate locomotion in patients with migraine and healthy controls during tasks that involve anticipatory control (obstacle crossing, stepping up and down a curb) with increasing levels of sensory disturbance (visual and auditory). And to verify if the clinical signs related to functional performance can be related to morphological brain changes Methods: Initially, for the first study 51 women with migraine and 22 healthy women performed three walking tasks: crossing an obstacle, stepping-up and stepping-down a curb, in a control situation with ambient lighting (≅350 lux), bright light (≅1200 lux), and loud sound (≅90 dBa). For the kinematic evaluation, the VICON motion capture system was used. The second study we considered of 45 women with migraine, and we only consider stepping-up and stepping-down tasks in a control situation with ambient lighting. Afterwards, these 45 volunteers underwent to analysis of the brain volumes and withe matter lesions which were calculated from 3 Tesla magnetic resonance imaging. For statistical analysis, in the first study a t-test, a Spearman correlation test, and a repeated measures mixed ANOVA were applied. And in the second study a multiple backward linear regression was used. Results: The first study showed that migraineurs presented higher discomfort induced by light (p ≤ 0.0001) and sound (p = 0.001). In the obstacle task, migraineurs had greater step width than controls in the ambient light condition (p = 0.038) and participants of both groups placed their leading foot farther away from the obstacle in the light (p = 0.033) than in the ambient light condition. For the step-up task, this distance increased for both groups and limbs in the light (leading limb: p = 0.015; trailing limb: p = 0.002) and sound (leading limb: p = 0.010; trailing limb: p ≤ 0.0001) conditions compared to the ambient light condition. Step speed increased for light and sound conditions compared to ambient light condition, except for the sound condition in the step-down task. In the second study in the step-up task, 31.4% of the step width variation was explained by subcortical gray volume, cingulate gyrus, and average withe matter lesions volume (p=0.001). And 31.2% of the step speed variation was explained by cerebellum, parietal lobe, and temporal lobe (p=0.001). In the step-down task, 37.3% of the step width variation was explained by the basal ganglia, brainstem, nucleus accumbens, cingulate gyrus and average withe matter lesions volume (p=0.002). And 25.1% of the step speed variation was explained by the volume of the cerebellum, parietal lobe, and temporal lobe (p=0.007). Conclusions: Although the discomfort induced by light and sound was higher in the migraine group, bright light and loud sound had an impact on functional activities, regardless of migraine status, except for step width in one task. Furthermore, the variability of functional performance during dynamic tasks possibly can be explained in parts by changes in the volume of brain regions, some specifically related to functional performance in migraine patients. Future studies are still needed to identify longitudinal changes in neuroimaging markers as possible predictors of poor functional performance in patients with migraine.Objetivo: Investigar a locomoção de pacientes com migrânea e controles saudáveis durante tarefas que envolvem controle antecipatório (ultrapassar obstáculos, subir e descer um degrau) com níveis crescentes de distúrbios sensoriais (visuais e auditivos). E verificar se os sinais clínicos relacionados ao desempenho funcional podem estar relacionados às alterações morfológicas do cérebro. Métodos: Inicialmente, para o primeiro estudo 51 mulheres com migrânea e 22 saudáveis realizaram três tarefas de caminhada: ultrapassar um obstáculo, subir e descer um degrau, em uma situação controle com iluminação ambiente (≅350 lux), luz forte (≅1200 lux) e som alto (≅90 dBa). Para a avaliação cinemática, foi utilizado o sistema de captura de movimento VICON. O segundo estudo considerou 45 mulheres com migrânea, e consideramos apenas as tarefas de subida e descida de degrau com iluminação ambiente. Posteriormente, essas 45 voluntárias foram submetidas à análise dos volumes cerebrais e lesões de substância branca que foram calculados a partir de imagens de ressonância magnética de 3 Tesla. Para análise estatística, no primeiro estudo foram aplicados um teste t, um teste de correlação de Spearman e uma ANOVA mista de medidas repetidas. No segundo estudo foi usada uma regressão linear múltipla, com método retroceder. Resultados: O primeiro estudo mostrou que os migranosos apresentam maior desconforto induzido pela luz (p ≤ 0,0001) e pelo som (p = 0,001). Na tarefa de obstáculo, os pacientes com migrânea tiveram uma largura de passo maior do que os controles na condição de luz ambiente (p = 0,038) e os participantes de ambos os grupos colocaram seu pé dianteiro mais longe do obstáculo na condição luz forte (p = 0,033) do que na condição de luz ambiente. Para a tarefa de subida de degrau, esta distância aumentou para ambos os grupos e pernas na condição luz (perna de abordagem: p = 0,015; perna de suporte: p = 0,002) e som (perna de abordagem: p = 0,010; perna de suporte: p ≤ 0,0001) em comparação com a condição de luz ambiente. A velocidade do passo aumentou para as condições de luz e som em comparação com a condição de luz ambiente, exceto para a condição som na tarefa de descida de degrau. No segundo estudo na tarefa de subida de degrau, 31,4% da variação da largura do passo foi explicada pelo volume cinza subcortical, giro cingulado e volume médio das lesões de substância branca (p = 0,001). E 31,2% da variação da velocidade do passo foi explicada pelo cerebelo, lobo parietal e lobo temporal (p = 0,001). Na tarefa de descida de degrau, 37,3% da variação da largura do passo foi explicada pelos gânglios da base, tronco encefálico, núcleo accumbens, giro cingulado e volume médio das lesões de substância branca (p = 0,002). E 25,1% da variação da velocidade do passo foi explicada pelo volume do cerebelo, lobo parietal e lobo temporal (p = 0,007). Conclusões: Embora o desconforto induzido pela luz e pelo som tenha sido maior no grupo migrânea, a luz forte e o som alto tiveram impacto nas atividades funcionais, independente da presença de migrânea. Além disso, a variabilidade do desempenho funcional durante tarefas dinâmicas pode ser explicada em partes por mudanças no volume das regiões do cérebro, algumas especificamente relacionadas ao desempenho funcional. Estudos futuros ainda são necessários para identificar mudanças longitudinais nos marcadores de neuroimagem como possíveis preditores do baixo desempenho funcional em pacientes com migrânea

Thoracic Spine Pain in High School Adolescents: A One-Year Longitudinal Study

Thoracic spine pain (TSP) is a common condition in the general adult population, with a similar prevalence in children and adolescents. An in-depth understanding of risk factors can assist in the identification of potential targets for effective prevention strategies. This study aimed to determine the incidence of TSP and ongoing TSP and identify its predictors in high school students. This longitudinal study was conducted in 2017 (baseline-T1), and follow-up surveys were completed in 2018 (T2). The variable “thoracic spine pain” was observed using the Nordic questionnaire, and associated variables were observed through the Baecke questionnaire and the Strengths and Difficulties Questionnaire. Statistical association methods were used for bivariate and multivariate logistic regression analysis. Among the participants, the one-year prevalence (ongoing TSP) was 38.4%, and the one-year incidence (new TSP) was 10.1%. Significant risk factors for ongoing TSP were adolescent females (RR = 2.14), in the age group of 15 to 18 years (RR = 1.41), clinical mental health problems (RR = 3.07), borderline mental health problems (RR = 2.02), mental health problems, sitting while using a tablet (RR = 1.93), distance of the eye from cell phone screen of or more than 20 cm (RR = 1.69), distance of the eye from the PC screen of or more than 30 cm (RR = 1.53), cell phone mobile use duration of or more than 3 h (RR = 1.60), tablet use time of or more than 3 h (RR = 2.08), and semi-lying prone position while using the cell phone (RR= 1.47), and these were also significant predictors of TSP episodes. Significant risk factors for new TSP were adolescent female sex (RR = 1.88), level, clinical mental health problems (RR = 4.26), borderline mental health problems (RR = 2.07), semi-lying prone position while using cell phone (RR = 1.71) or tablet (RR = 2.31), and mobile phone use duration equal to or greater than 3 h (RR = 1.72). We conclude that there is a high prevalence of TSP in high school students, which is associated with the female sex, mental health problems, and use of electronic devices for an inappropriate duration in an improper position

Efeitos do horário de desempenho de atividade laboral e de hábitos de vida sobre aspectos metabólicos e reprodutivos em uma população da cidade de Bauru-SP - Brasil

Ritmos circadianos podem ser definidos como mudanças em eventos fisiológicos e comportamentais que ocorrem em um período de 24 horas. O objetivo do presente trabalho foi avaliar como mudanças nos ritmos circadianos, exibida por trabalhadores noturnos/de turnos, contribuem para o desenvolvimento e para a prevalência de síndromes metabólicas, como diabetes, hipertensão e obesidade, quando associadas com fatores como idade, gênero e hábitos de alimentação e tabagistas. Esse estudo também considerou a influência de todos os fatores supracitados na manutenção da fertilidade dos indivíduos. Dados foram coletados por meio da aplicação de um questionário respondido por uma população de 600 indivíduos de ambos os gêneros na cidade de Bauru, São Paulo, Brasil. Indivíduos de ambos os gêneros foram agrupados em três categorias de idade: 20-35 anos; 39-59 anos; e acima de 60 anos. Cada categoria de gênero/idade continha 100 indivíduos (n=600; 45 homens e 12 mulheres eram trabalhadores noturnos/turno; e 255 homens e 288 mulheres eram trabalhadores de horário comercial). Nossos resultados não demonstram mudanças nos fatores considerados (incidência de diabetes, hipertensão ou obesidade) entre os trabalhadores noturnos/turno de ambos os sexos mais jovens (20-35 anos). Mulheres trabalhadoras noturnas/turno na categoria “36-59 anos” apresentaram alta incidência de hipertensão, e a hipertensão estava associada com maus hábitos de alimentação e tabagismo. Homens acima de 60 anos que trabalharam em turno/noturno apresentaram alta incidência de diabetes, hipertensão e obesidade e todos esses fatores foram associados com tabagismo. Em conclusão, nossos dados demonstraram o efeito do tempo de exposição às alterações nos ritmos circadianos sobre a prevalência de síndromes metabólicas. Também observamos que mulheres são mais susceptíveis a essas alterações do que homens.  Os dados de fertilidade coletados no presente estudo foram inconclusivos. ABSTRACT Effects of Work Hours and Lifestyle on Metabolic and Reproductive Facets of a Brazilian Population (Bauru, Sao Paulo, Brazil)Circadian rhythms can be defined as changes in physiological and behavioral events within a 24 hours period. The aim of the present study was to evaluate how changes to circadian rhythms in shift workers contribute to the development and the prevalence of metabolic disorders, such as diabetes, hypertension, obesity when associated with factors such as gender, age, and smoking and eating habits. This study also considers the influence of these factors on individual fertility. The study was performed by analyzing data collected in a survey. The survey was answered by a population of 600 individuals of both genders in the city of Bauru, São Paulo State, Brazil. Individuals of both genders were grouped in three different age categories: 20-35 years old; 36-59 years old; and 60 years old and older. Each age/gender category contained one hundred individuals (n= 600; 45 men and 12 women were shift workers, and 255 men and 288 women worked regular business hours). Our results showed no changes in the factors considered (incidence of diabetes, hypertension, and obesity) among younger shift workers (20-35 years old) of either gender in our population. Shift-working women in the “36-59 years old” category presented a high incidence of hypertension, and this hypertension was associated with poor diet and smoking habits. Shift-working men in the “60 years old and older” category presented high incidences of diabetes, hypertension, and obesity; all of these factors were associated with smoking habits. In conclusion, our data showed the effect of the extent of circadian rhythm disruption on the prevalence of metabolic syndrome. We also found that women seem to suffer the effects of the circadian rhythm disruption earlier in life than men. Fertility data were not conclusive in our study

Multisensory and closed kinetic chain exercises on the functional capacity and balance in elderly women: blinded randomized clinical trial

Abstract Introduction: The aging process causes losses that lead to decreased balance, gait speed and functional capacity and, therefore, there is a need of specific protocols to work preventively these variables, which will contribute to the decrease in the frequency of falls in this population. Objective: Verify the effect of a program of multisensory and closed kinetic chain exercises on the functional capacity and balance in elderly women. Methods: Randomized clinical trial masked (blind). Subjects were 32 elderly women from the Centro de Convivência of the Bauru Department of Social Welfare (Secretaria de Bem-Estar Social de Bauru) distributed in two groups: control (CG = 15) and experimental (EG = 17). Interventions: The program of multisensory and closed kinetic chain exercises was applied during an hour, once a week, for 12 weeks. Main measures: Functional capacity was measured by Timed Up and Go (TUG) and the 10-meter walking test (TC10) and their balance by the Berg Balance Scale (BBS). Results: Regarding the comparison between the moments M1 and M2 of the EG after the intervention, there was a statistically significant increase in the functional capability (p = 0.00006), walking speed (p = 0.0008) and balance (p = 0.0006). Conclusion: The multisensory and closed kinetic chain-training program indicated a beneficial effect in the improvement of the elderly women balance and functional performance

Prevalence and factors associated to back pain in adults from the northeast of São Paulo, Brazil: a population-based study

Abstract Introduction: Back pain has become a serious public health problem. Objective: To determine the prevalence of back pain in a population-based sample of subjects over 20 years old living in the city of Bauru (São Paulo, Brazil) and to analyze the associations to variables- sociodemographic, ergonomic and lifestyle-related - and to morbidity. Methods: a cross-sectional study which evaluated 600 adults over 20 years old, both gender and living in the city. We used a structured protocol and the Nordic questionnaire. Also, we developed a descriptive analysis, bivariate and multivariate by binary logistic regression. Results: The prevalence of back pain was of 50.3% (CI 46.3 to 54.3), since 42.3% (CI 36.9 to 48.0) in men and 57.6% (CI 51.9 to 63.0) in women, with statistical significant difference (p = 0.001). Different variables remained in final models when assessed by gender. For male to be widowed and divorced and smoking habits and, for women to be widowed and divorced, to work in seated position and to perform occupational activities that demand carrying and lifting weight. Conclusion: We verified high prevalence in back pain in the population of Bauru and high association to widowed/divorced in both gender, with women performing occupational activities usually or always in seated position, those who carry or lift weight in work and men who smoke

Multisensory and closed kinetic chain exercises on the functional capacity and balance in elderly women: blinded randomized clinical trial

<div><p>Abstract Introduction: The aging process causes losses that lead to decreased balance, gait speed and functional capacity and, therefore, there is a need of specific protocols to work preventively these variables, which will contribute to the decrease in the frequency of falls in this population. Objective: Verify the effect of a program of multisensory and closed kinetic chain exercises on the functional capacity and balance in elderly women. Methods: Randomized clinical trial masked (blind). Subjects were 32 elderly women from the Centro de Convivência of the Bauru Department of Social Welfare (Secretaria de Bem-Estar Social de Bauru) distributed in two groups: control (CG = 15) and experimental (EG = 17). Interventions: The program of multisensory and closed kinetic chain exercises was applied during an hour, once a week, for 12 weeks. Main measures: Functional capacity was measured by Timed Up and Go (TUG) and the 10-meter walking test (TC10) and their balance by the Berg Balance Scale (BBS). Results: Regarding the comparison between the moments M1 and M2 of the EG after the intervention, there was a statistically significant increase in the functional capability (p = 0.00006), walking speed (p = 0.0008) and balance (p = 0.0006). Conclusion: The multisensory and closed kinetic chain-training program indicated a beneficial effect in the improvement of the elderly women balance and functional performance.</p></div

Relationship between the Somatosensory Cortex Morphology, Cutaneous Allodynia, and Clinical Features of Patients with Migraine

Recent studies have demonstrated the presence of brain alterations in patients with migraine. Functional and vascular changes in the brain are related to the presence and severity of cutaneous allodynia. However, the association between brain structural changes and cutaneous allodynia has not been yet investigated in patients with migraine. Thus, the purpose of this study was to evaluate the correlation between the severity of cutaneous allodynia, migraine features, and the thickness and volume of the somatosensory cortex. Forty-five patients with migraine, with and without aura and chronic migraine, were included. Volunteers filled out the Allodynia Symptom Questionnaire (ASC-12/Brazil) and were evaluated via magnetic resonance imaging (MRI). The images were inspected by a blinded neuroradiologist and analyzed with Freesurfer software. Correlation tests and a linear regression model were used to evaluate the relationship among the outcomes. The somatosensory cortex thickness and volume were not different among migraine subgroups (p &gt; 0.05). There was no significant correlation between the somatosensory thickness and volume with the ASC-12/Brazil, migraine frequency, intensity, migraine onset or aura frequency. The ASC-12/Brazil score variability cannot be predicted by the somatosensory cortex thickness or volume. The results show that the somatosensory cortex morphology is neither associated with cutaneous allodynia nor with migraine features among migraineurs