Is kinesiophobia associated with disturbances in dynamic balance in individuals with chronic non-specific low back pain? / A cinesiofobia está associada a distúrbios de equilíbrio dinâmico em indivíduos com dor lombar crônica não-específica?

ABSTRACT BACKGROUND AND OBJECTIVES: Chronic non-specific low back pain is a disabling condition that has a high worldwide prevalence. The aim of the study was to investigate the association between deficits in dynamic balance, age and body mass index (BMI), and kinesiophobia, as well as to establish a comparison between men and women. METHODS: A cross-sectional study with 145 individuals between 18 and 50 years of age with non-specific chronic low back pain. Sociodemographic data were collected, and dynamic balance was assessed using the Y-Balance Test. The Tampa Scale was used to assess kinesiophobia. A linear regression was applied to investigate the association between kinesiophobia and a set of predictor variables (balance, gender, BMI). Men and women were compared using the Student's t-test (kinesiophobia and dynamic balance). RESULTS: The overall mean kinesiophobia score was 41.3. The Y-Balance Test mean for the right and left lower limb, respectively, was 59.4 and 59.5. An association was found between kinesiophobia and two predictors: balance and BMI (R2:6.8%). No significant differences were found between gender for kinesiophobia (42.1 for women and 40.3 for men). However, women had worse dynamic balance compared to men (mean reach of 56.1 versus 63.5, respectively; p<0.05). CONCLUSION: Kinesiophobia was found to be associated with disturbances in dynamic balance and BMI of individuals with non-specific chronic low back pain. However, the model explained a small variation in kinesiophobia. Women showed worse dynamic balance compared to with men.

RESUMO JUSTIFICATIVA E OBJETIVOS: A dor lombar crônica não-específica é uma condição incapacitante que possui alta prevalência mundial. O objetivo deste estudo foi analisar a associação entre déficits do equilíbrio dinâmico, idade e índice de massa corporal (IMC) e a cinesiofobia, além de realizar uma comparação entre homens e mulheres. MÉTODOS: Este estudo transversal incluiu 145 indivíduos com idade entre 18 e 50 anos com dor lombar crônica não-específica. Foram coletados dados sociodemográficos. O equilíbrio dinâmico foi avaliado por meio do Y-Balance Test. A escala Tampa foi usada para avaliar a cinesiofobia. Aplicou-se uma regressão linear para investigar a associação entre cinesiofobia e um conjunto de variáveis preditoras (equilíbrio, sexo, IMC). Homens e mulheres foram comparados por meio do teste T de Student (cinesiofobia e equilíbrio dinâmico). RESULTADOS: O escore médio geral de cinesiofobia foi de 41,3. A média do Y-Balance Test para o membro inferior direito e esquerdo, respectivamente, foi de 59,4 e 59,5. Verificou-se uma associação entre cinesiofobia e dois preditores, a saber, equilíbrio e IMC (R2:6,8%). Não foram encontradas diferenças significantes entre sexo para cinesiofobia (42,1 para mulheres e 40,3 para homens). Entretanto, as mulheres apresentaram pior equilíbrio em comparação aos homens (média de 56,1 de alcance versus 63,5, respectivamente; p<0,05). CONCLUSÃO: Verificou-se que a cinesiofobia apresentou associação com distúrbios no equilíbrio dinâmico e IMC de indivíduos com dor lombar crônica não-específica. Entretanto, o modelo explicou uma pequena variação na cinesiofobia. As mulheres apresentaram um pior equilíbrio dinâmico em comparação aos homens.

Age and gender characteristics of patients affected with multiple sclerosis in Hungary between 2004 and 2016 / A hazai sclerosis multiplex betegpopuláció életkori és nemi megoszlása 2004 és 2016 között.

Összefoglaló. Bevezetés: Mivel hazánkban a sclerosis multiplex gyakoriságáról, valamint életkori és nemi jellegzetességeirol az elmúlt évtizedekben - egészen 2020-ig - csak regionális jellegu felmérések készültek egy-egy centrum betegforgalma alapján, az újonnan diagnosztizált és már ismert betegek országos koreloszlásáról és annak idobeli változásairól nincsenek ismereteink. Célkituzés: Jelen munkánkban több mint 14 000 beteg adatainak elemzésével a prevalens és incidens betegek koreloszlásának változását vizsgáljuk 2004-2016 során, és eredményeinket összevetjük az elmúlt évtizedekben közölt hazai adatokkal. Módszer: Munkacsoportunk az egészségbiztosítási pénztár anonimizált NEUROHUN adatbázisát elemezte, amely tartalmazza a 2004 és 2016 között az összes hazai, államilag finanszírozott, a fekvo- és járóbeteg-szakellátásból neurológiai diagnózissal jelentett esetet. A sclerosis multiplex BNO-kódjának elofordulása alapján korábban létrehoztuk a betegség adminisztratív definícióját, és megbecsültük a sclerosis multiplex országos prevalenciáját és incidenciáját. Eredmények: A prevalens betegek átlagéletkora 2015-ben 47,9 év, ugyanebben az évben az incidens betegek átlagéletkora 37,4 év volt. Vizsgálatunk szerint a prevalens betegek átlagéletkora szignifikánsan - évente egyötöd-egyharmad évvel (p<0,001) - emelkedik, mégpedig a nok esetében nagyobb mértékben. A nok átlagosan fél évvel idosebbek, mint a férfi páciensek (szignifikáns különbség: p = 0,002). A prevalens betegekben a legnépesebb korosztály az ötvenévesek felol a fiatalabb, 35-40 éves korosztály felé mozdul. Az incidens betegek átlagéletkora lassan, de szignifikánsan - évente átlagosan egyharmad évvel (p<0,001) - csökken. Következtetés: Eredményeink szerint az újonnan diagnosztizált sclerosis multiplexes páciensek átlagosan egyre fiatalabbak, és a prevalens betegek között is egyre fiatalabb korosztályok a legnépesebbek, de a javuló túlélés és a hosszabb élettartam miatt a prevalens betegek átlagéletkora összességében valószínuleg fokozatosan emelkedik. Orv Hetil. 2021; 162(19): 746-753. INTRODUCTION: The nationwide age and gender distribution of newly diagnosed and prevalent multiple sclerosis patients has been unknown in Hungary, as until 2020 only regional studies had been reported about the frequency and age characteristics of subjects with multiple sclerosis, based on single-center patient registries. OBJECTIVE: In the present study with the analysis of over 14 000 patients, we describe the changes in age distribution of prevalent and incident subjects between 2004 and 2016 and compare our results with the data published on the subject during the last decades in Hungary. METHOD: We have analyzed the pseudonymized NEUROHUN database provided by the single-payer National Health Insurance Fund, that contains each claim submitted by public hospitals and outpatient services for neurologic diseases between 2004 and 2016. Using the ICD10-code of multiple sclerosis, we have previously established the administrative definition of the illness and estimated its prevalence and incidence in the country. RESULTS: The mean age of prevalent patients was 47.9 years in 2015, whereas in the same year the mean age of incident cases was 37.4 years. The average age of prevalent patients shows a significant rise - with an annual increase of one fifth-one third year (p<0.001) - with a more pronounced increase among women. The age of women is higher by half a year (p = 0.002). The most populous age groups among prevalent subjects shift from the fifties towards the younger generations between 35-40 years of age. The average age of incident subjects slowly, but significantly decreases, with a mean annual decrease of about one third year (p<0.001). CONCLUSION: Our results suggest that though new patients are younger year-by-year and the most populous age groups are also younger, altogether the average age of prevalent subjects continuously increases, probably due to the longer survival and lifespan of patients with multiple sclerosis. Orv Hetil. 2021; 162(19): 746-753.

Mean limb length discrepancy after total hip arthroplasty.

BACKGROUND: Limb length discrepancy (LLD) is one of the most common complications of primary total hip arthroplasty (THA) causing patients dissatisfaction. In this study we determined the mean of preoperative limb length discrepancy (LLD), postoperative LLD after THA and their difference. Previously very little literature is available on this topic in Pakistan, so the results of my study will be a useful addition in the existing as well as local literature. Also, on the basis of these results, need of some preoperative planning and executing the plan in the operating room to eliminate LLD can be recommended. METHODS: It is a descriptive case series study (Clinical Practice Article) conducted on 44 patients undergoing primary Total Hip arthroplasty (THA) at orthopaedics department Madinah Teaching Hospital Faisalabad from Sep 2018 to Sept 2019. Patients having age between 18-70 years including both genders were studied with non-probability, consecutive sampling. RESULTS: In our study mean of pre-operative LLD is -19.02 with standard deviation of 21.31 and mean of post-operative LLD is 7.25 mm with standard deviation of 9.46. This study tells that 91% of patients undergoing primary THA without using any method to eliminate LLD have postoperative LLD but 88.6% of patients (39 patients out of 44) have postoperative LLD in the range of 0 to ±10 mm which is not much significant. But 11.4% of patients (5 patients out of 44) have postoperative LLD >10 mm which causes functional impairment. CONCLUSION: We can say that in most of the patients postoperative LLD after primary THA is very minimal and within acceptable range in experienced hands but a few patients can have a significant LLD in order to gain better joint stability which can be compensated by shoe wears.

Characteristics of Chinese chronic cough patients.

Chronic cough is one of the most common complains for patients seeking medical attention in both general practice and respiratory specialist clinics. Cough variant asthma, eosinophilic bronchitis, upper airway cough syndrome, as well as gastro-esophageal reflux disease are common conditions associated with chronic cough, and cough variant asthma, eosinophilic bronchitis account for a higher proportion of patients with chronic cough in China than in Western countries. An older female predominance has been reported in most Western countries, which may be attributed to a higher cough reflex sensitivity in females, especially those post-menopausal females. However, studies conducted in China showed that patients with chronic cough have a nearly similar gender distribution and most of them are in their late 30s or early 40s, despite the similar gender and age difference in cough reflex sensitivity as Western countries. Environmental and occupational exposures, cigarette smoking, unhealthy lifestyle might play a role in the distinct age and gender distribution of Chinese chronic cough patients, yet further study is needed to clarify it.

Audiometria de resposta evocada de acordo com sexo e idade: achados e aplicabilidade / Evoked response audiometry according to gender and age: findings and usefulness

A audiometria de respostas evocadas (ABR) é um registro não-invasivo de potenciais elétricos auditivos nos primeiros 12 milissegundos, da orelha média ao córtex auditivo. ABR é importante na avaliação otoneurológica. OBJETIVO: Esclarecer as utilidades do exame, faixas etárias e sexo com maior incidência e topodiagnóstico segundo as latências absolutas e os intervalos interpicos. CASUÍSTICA E MÉTODO: Neste estudo retrospectivo foram analisados 403 prontuários de ABR realizados em clínica particular na cidade de Jundiaí/SP, Brasil, suspeitos de alteração auditiva e/ou doença do SNC, com os pacientes divididos por sexo e faixa etária. RESULTADOS E CONCLUSÕES: ABR é um importante exame para determinar a integridade da via auditiva, limiares eletrofisiológicos e topodiagnóstico, embora o teste não indique a etiologia das alterações. Foi demonstrado que ocorreu maior incidência de achados retrococleares na faixa etária de 12-20 anos e sexo masculino, contudo crianças menores de um ano com fatores de risco não apresentaram um aumento na incidência de alterações condutivas, cocleares e retrococleares em relação à população geral estudada. As latências absolutas das ondas I, III e V foram maiores no sexo masculino e as alterações dos intervalos interpicos foram similares em ambos os sexos, sendo que o intervalo I-III foi o mais freqüentemente alterado.

Auditory evoked brainstem responses (ABR) is a non-invasive electrical potential registration which evaluates the auditory tract from the middle ear to the auditory cortex in the first 12 milliseconds (ms). The ABR is an important otoneurological evaluation. AIM: confirm the test's usefulness, major incidence and topography according to are range gender considering the absolute latencies of the waves and interpeak intervals. MATERIALS AND METHOD: we retrospectively analyzed 403 tests from a private clinic in the city of Jundiaí-São Paulo State-Brazil, from patients suspected of auditory damage or central nervous disorder, and the patients were broken down according to gender and age. RESULTS AND CONCLUSIONS: ABR is an important test to determinate the soundness of the auditory tract, the electrophysiological thresholds and topodiagnosis. We found no differences between type of loss and gender; there was a major incidence of retrocochlear findings among male patients between 12-20 years old; children under one year with risk factors did not present higher incidences of auditory findings when compared with all the population analyzed. The absolute latencies of waves I, III and V were higher in males, but the interpeak intervals were similar in both genders, showing that interval I-III was more frequently altered.