Prognostic Role of Demographic, Injury and Claim Factors in Disabling Pain and Mental Health Conditions 12 Months after Compensable Injury.

Identifying who might develop disabling pain or poor mental health after injury is a high priority so that healthcare providers can provide targeted preventive interventions. This retrospective cohort study aimed to identify predictors of disabling pain or probable mental health conditions at 12 months post-injury. Participants were recruited 12-months after admission to a major trauma service for a compensable transport or workplace injury (n = 157). Injury, compensation claim, health services and medication information were obtained from the Victorian Orthopaedic Trauma Outcome Registry, Victorian State Trauma Registry and Compensation Research Database. Participants completed questionnaires about pain, and mental health (anxiety, depression, posttraumatic stress disorder) at 12 months post-injury. One third had disabling pain, one third had at least one probable mental health condition and more than one in five had both disabling pain and a mental health condition at 12 months post-injury. Multivariable logistic regression found mental health treatment 3-6 months post-injury, persistent work disability and opioid use at 6-12 months predicted disabling pain at 12 months post-injury. The presence of opioid use at 3-6 months, work disability and psychotropic medications at 6-12 months predicted a mental health condition at 12 months post-injury. These factors could be used to identify at risk of developing disabling pain who could benefit from timely interventions to better manage both pain and mental health post-injury. Implications for healthcare and compensation system are discussed.

Genetic characterization of the spike gene of porcine epidemic diarrhea viruses (PEDVs) circulating in Vietnam from 2015 to 2016.

BACKGROUND: Porcine epidemic diarrhea (PED) is a highly contagious swine disease caused by the PED virus (PEDV), which is a member of the family Coronaviridae. Since the first outbreaks in Belgium and the United Kingdom were reported in 1971, PED has spread throughout many countries around the world and causing significant economic loss. This study was conducted to investigate the recent distribution of PEDV strains in Vietnam during the 2015-2016 seasons. METHODS: A total of 30 PED-specific PCR-positive intestinal and faecal samples were collected from unvaccinated piglets in Vietnam during the 2015-2016 seasons. The full length of the spike (S) gene of these PEDV strains were analysed to determine their phylogeny and genetic relationship with other available PEDV strains globally. RESULTS: Phylogenetic analysis of the complete S gene sequences revealed that the 28 Vietnamese PEDV strains collected in the northern and central regions clustered in the G2 group (both G2a and G2b sub-groups), while the other 2 PEDV strains (HUA-PED176 and HUA-PED254) collected in the southern region were clustered in the G1/G1b group/sub-group. The nucleotide (nt) and deduced amino acid (aa) analyses based on the complete S gene sequences showed that the Vietnamese PEDV strains were closely related to each other, sharing nt and aa homology of 93.2%-99.9% and 92.6%-99.9%, respectively. The N-glycosylation patterns and mutations in the antigenic region were observed in Vietnamese PEDV strains. CONCLUSIONS: This study provides, for the first time, up-to-date information on viral circulation and genetic distribution, as well as evidence to assist in the development of effective PEDV vaccines in Vietnam.

Fatigue in sarcoidosis and exercise tolerance, dyspnea, and quality of life.

Fatigue is one of the major symptoms reported by sarcoidosis patients. The relationship between fatigue and clinical course of sarcoidosis remains unclear. The aim of the study was to evaluate the relationship between fatigue and lung function tests, exercise tolerance, dyspnea, and quality of life among sarcoidosis patients. One hundred eleven sarcoidosis patients completed the following questionnaires: Fatigue and Assessment Scale (FAS), Quality of Life Scale (SF-36), and dyspnea scales: Medical Research Council Questionnaire, Baseline Dyspnea Index, and Oxygen Cost Diagram. Clinical parameters (FVC, FEV1, DLCO, VO2, and VO2/AT, and work load) were derived from the patients' medical files. The exercise tolerance was the only clinical parameter associated with fatigue (Max. Work Load -0.65, VO2 -0.42, VO2/AT -0.51). No correlations were found between FAS and spirometry or diffusing tolerance. Fatigue correlated with all dyspnea domains by means of (r values ranging from 0.47 to 0.77 in multivariate regression analysis) and with quality of life in SF-36 questionnaire (r values ranging from -0.33 to -0.83). We conclude that FAS seems a reliable and valid indicator of dyspnea level, quality of life, and exercise tolerance in sarcoidosis patients.