ABSTRACT
OBJECTIVE: Fluorine-18-fluorodeoxyglucose (18F-FDG) PET/CT is a promising diagnostic tool for polymyalgia rheumatica (PMR) and large vessel vasculitis (LVV). PET/CT performance is recommended before the onset of steroid therapy because glucocorticoids (GC) may decrease the intensity of FDG uptake. However, this is not always possible in clinical practice. Our aim was to assess if PET/CT could be also useful to detect musculoskeletal and vascular involvement in patients receiving GC. METHODS: Single-center study of patients with PMR diagnosis based on 2012 EULAR/ACR criteria who underwent a PET/CT scan due to LVV suspicion. We compared the musculoskeletal and vascular FDG uptake between two groups: (a) steroid-naïve and (b) steroid-resistant patients. A sub-analysis was conducted in patients who were receiving GC to discern if the cumulative prednisone dose influences the FDG uptake. RESULTS: We evaluated 75 patients (27 men/ 48 women); mean age±SD: 68.2 ± 10.7 years. PET/CT was performed in 14 steroid-naïve and 61 steroid-resistant patients. Patients under GC had received a median cumulative prednisone dose of 1.8 [0.6-3.9] g. The pattern of musculoskeletal FDG uptake was similar in steroid-naïve and steroid-resistant patients. FDG uptake in the vessel wall was more frequently detected in steroid-naïve patients. However, PET/ CT was also useful to detect LVV in 62.3 % of the patients who were receiving GC. The percentage of patients who had positive PET/CT scans tended to decrease with higher cumulative prednisone doses. CONCLUSION: Even though GC therapy may decrease the 18-FDG uptake, PET/CT continues to be a useful tool to detect musculoskeletal and LVV involvement in PMR.
Subject(s)
Fluorodeoxyglucose F18 , Glucocorticoids , Polymyalgia Rheumatica , Positron Emission Tomography Computed Tomography , Radiopharmaceuticals , Humans , Polymyalgia Rheumatica/drug therapy , Polymyalgia Rheumatica/diagnostic imaging , Positron Emission Tomography Computed Tomography/methods , Male , Female , Aged , Glucocorticoids/administration & dosage , Glucocorticoids/therapeutic use , Middle Aged , Prednisone/therapeutic use , Prednisone/administration & dosage , Retrospective Studies , Aged, 80 and over , Giant Cell Arteritis/diagnostic imaging , Giant Cell Arteritis/drug therapyABSTRACT
A Covid-19 proporcionou mudanças na educação presencial, substituída pelo ensino remoto, gerando consequências na saúde dos professores. A pandemia pode ter gerado novas alterações osteomusculares nos docentes ou intensificado preexistentes. Objetivou-se avaliar o tempo que os docentes atuaram remotamente, analisando as incidências de alterações osteomusculares. A coleta de dados ocorreu em 2021 utilizando Google forms. Foram 92 respostas, de profissionais lecionando entre um e dois anos (76,1%), consequentemente > 60% ficam por mais de seis horas em frente à tela do computador, 96,7% dos docentes têm algum tipo de dor osteomuscular e 33,7% afirmam que as dores iniciaram após passar a trabalhar em frente ao computador. As principais regiões com dores são a cervical, ombros e lombar. A postura inadequada combinada a móveis não ergonômicos afetam a musculatura postural, levando à fadiga e dor. A mudança do modo de trabalhar levou a um desequilíbrio biopsicossocial, que deve ser investigado futuramente.
Covid-19 led to changes in face-to-face education, replaced by remote teaching, leading teachers to health consequences. The pandemic may have generated new musculoskeletal changes in teachers or intensified pre-existing ones. The objective was to evaluate the time during which professors worked remotely, analyzing the incidence of musculoskeletal alterations. Data collection took place in 2021 using Google forms. There were 92 responses, of those teaching between one and two years (76.1%), with more than 60% staying for more than six hours in front of the computer screen, 96.7% of professors have some type of musculoskeletal pain, and 33.7% claim that the pain started after they started working in front of the computer. The main regions with pain are the cervical area, shoulders, and lumbar area. Inadequate posture combined with non-ergonomic furniture affect postural muscles, leading to fatigue and pain. The change in the way of working led to a biopsychosocial imbalance and shall be further investigated.
El Covid-19 brindó cambios en la educación presencial, sustituida por la enseñanza a distancia, lo que llevó a los docentes a consecuencias para la salud. La pandemia puede haber generado nuevos cambios musculoesqueléticos en los docentes o intensificado los preexistentes. El objetivo fue evaluar el tiempo que los profesores estaban trabajando de forma remota, analizando la incidencia de alteraciones musculoesqueléticas. La recopilación de datos se realizó en 2021 mediante formularios de Google. Hubo 92 respuestas, enseñando entre uno y dos años (76.1%), además de > 60% permanecen más de seis horas frente a la pantalla de la computadora, 96.7% de los profesores tienen algún tipo de dolor musculoesquelético y 33,7% afirma que el dolor comenzó después de empezar a trabajar frente a la computadora. Las principales regiones con dolor son cervicales, hombros y lumbares. La postura inadecuada combinada con muebles no ergonómicos afecta los músculos posturales y causa fatiga y dolor. El cambio en la forma de trabajar resultó un desequilibrio biopsicosocial, cuyos problemas futuros deben ser investigados
Subject(s)
Faculty , Pandemics , Musculoskeletal Pain , COVID-19ABSTRACT
Introduction: The recent professionalization of trail running has focussed the interest in this sport. The aim is to describe the epidemiology of musculoskeletal injuries and illnesses among professional Spanish trail runners team during the month of training prior to the World Mountain and Trail Running Championship 2022.Material and Methods33 professional athletes from Spanish National Team that competed in the World Championship participated in the study. They completed a pre-participation health questionnaire based on the specific questionnaire "Oslo Sport Trauma Research Center - Health 2″.Results55% of the athletes suffered a musculoeskeletal injury or health problem during the last month. 12% had to modify their performance in a moderate or severe way. By anatomic location the foot was the most affected with 33% of the cases, followed by the ankle in 25%. Among the diagnoses, chronic overuse musculoskeletal injuries represented 80% with tendinopathy being the most frequent. Regarding the symptons 53% affected upper respiratory tract and 23% gastrointestinal problems.ConclusionsThere is a high risk for the professional trail runners who carry out a continued practice of trail running to suffer an injury or health problem, although most of such injuries or health problems have little impact on their sports performance. The foot and the upper respiratory system are the most affected. (AU)