Return to work after sick leave due to musculoskeletal disorder or injury: a longitudinal study conducted in Brazil.

BACKGROUND: Musculoskeletal disorders and injuries (MSDI) are conditions that affect the locomotor system characterized by pain and impairment of functionality. They are the leading cause of years lived with disability. The aim of this study was to analyze the factors that influence the return to work (RTW) among workers on sick leave due to MSDI.   METHODS: A longitudinal study was conducted in the city of São Paulo, Brazil, between 2020-2022. The participants were 216 workers who required social security compensation due to MSDI. They filled out online questionnaires about their sociodemographic characteristics, health risk behaviors, work characteristics and health conditions. They were followed for 365 days after their first day of sick leave. A Cox regression was performed to identify the factors that influenced their first RTW. RESULTS: Most participants were male (53.0%), mean age was 39.5 years (SD 10.6), 70.4% returned to work within the one-year follow-up period. The mean duration of sick leave was 192.6 days. Factors associated with a lower RTW were age 40 years and older (HR 0.54; 95%CI 0.39-0.76) and the interaction between perceptions of the need for improvement in the physical and psychological domains of quality of life (HR 0.67; 95%CI 0.48-0.94). CONCLUSIONS: Occupational healthcare professionals should pay greater attention to patients who are aging and those with perceived worse physical and psychological conditions, in order to facilitate the reintegration process and promote sustained RTW after sick leave due to musculoskeletal disorder or injury.

Identification of two patterns of mitochondrial DNA-copy number variation in postcentral gyrus during aging, influenced by body mass index and type 2 diabetes.

AIMS: Mitochondrial (mt) DNA replication is strongly associated with oxidative stress, a condition triggered by aging and hyperglycemia, both of which contribute to mitophagy disruption and inflammation. This observational exploratory study evaluated mtDNA-copy number (mtDNA-CN) and expression of genes involved in mitochondriogenesis (PPARGC1A, TFAM, TFB1M, TFB2M), mitophagy (PINK1, PRKN), and inflammatory pathways triggered by hyperglycemia (TXNIP, NLRP3, NFKB1), in the postcentral gyrus of adults and older individuals with and without type 2 diabetes mellitus (T2D). MAIN METHODS: Quantitative real-time PCR was employed to evaluate mtDNA-CN and gene expression; tissue autofluorescence, a marker of aging and of cells with damaged organelles, was also quantified. KEY FINDINGS: No correlation was found between age and mtDNA-CN, but a direct correlation was observed for cases with mtDNA-CN >1000 (r = 0.41). The mtDNA-CN >1000 group had greater tissue autofluorescence and higher body mass index compared to the mtDNA-CN <1000 group (BMI; 25.7 vs 22.0 kg/m2, respectively). mtDNA-CN correlated with tissue autofluorescence in the overall sample (r = 0.55) and in the T2D group (r = 0.64). PINK and PRKN expressions were inversely correlated with age. Mitochondriogenesis genes and TXNIP expressions were higher in the T2D group, and correlations among the mitochondriogenesis genes were also stronger in this group, relative to the subgroup with mtDNA-CN >1000.