1.
Efficacy and tolerability of orally administered tramadol/dexketoprofen fixed-dose combination compared to diclofenac/thiocolchicoside in acute low back pain: experience from an Italian, single-centre, observational study.
Meloncelli, S, Divizia, M, Germani, G
Current medical research and opinion. 2020;(10):1687-1693
Abstract
OBJECTIVES To compare the analgesic efficacy and tolerability of tramadol/dexketoprofen 75/25 mg (TRAM/DKP) versus diclofenac/thiocolchicoside 75/4 mg (DIC/THIO) in patients with moderate-to-severe acute low back pain (LBP). METHODS Single-centre, observational study in 82 adult outpatients with LBP due to disc herniation (≥4 Numerical Rating scale, NRS) who received either oral TRAM/DKP (n = 44) or intramuscular DIC/THIO (n = 38), both given every 12 h for 5 days. The primary endpoint was the change from baseline in pain intensity (PI) at pre-specified post-dose time points (t day1, t day3, t day7) and compared between the two treatments. Additional endpoints, all evaluated at day 7, included: the sum of PI difference (SPID), percentage of responders in terms of PI reduction versus baseline and change from baseline in Douleur Neuropathique (DN4) score. Tolerability and safety were also assessed. RESULTS Both treatment groups were comparable for demographic characteristics and comorbidities. Over the 5-day treatment period and up to day 7, compared to DIC/THIO, TRAM/DKP provided a significantly greater and sustained analgesia at day 3 and day 7 (p < .0001), with a higher proportion of responders at each time point [75% versus 71.1% (p = 0.687) at day 1, 93.2% versus 73.7% at day 3 (p = .016) and 95.5% versus 71.1% at day 7 (p = .003)], higher values of SPID (770.9 ± 23.5 vs. 507.1 ± 22.6; p < .0001) and significantly greater reduction in DN4 score [-62.7 ± 25.6 vs. -39.7 ± 31.2 (p < .0001)]. Both treatments were well tolerated. CONCLUSIONS Orally administered TRAM/DKP 75/25 mg can be a valuable and effective option in patients with acute LBP.
2.
Psychological Features and Their Relationship to Movement-Based Subgroups in People Living With Low Back Pain.
Karayannis, NV, Jull, GA, Nicholas, MK, Hodges, PW
Archives of physical medicine and rehabilitation. 2018;(1):121-128
Abstract
OBJECTIVE To determine the distribution of higher psychological risk features within movement-based subgroups for people with low back pain (LBP). DESIGN Cross-sectional observational study. SETTING Participants were recruited from physiotherapy clinics and community advertisements. Measures were collected at a university outpatient-based physiotherapy clinic. PARTICIPANTS People (N=102) seeking treatment for LBP. INTERVENTIONS Participants were subgrouped according to 3 classification schemes: Mechanical Diagnosis and Treatment (MDT), Treatment-Based Classification (TBC), and O'Sullivan Classification (OSC). MAIN OUTCOME MEASURES Questionnaires were used to categorize low-, medium-, and high-risk features based on depression, anxiety, and stress (Depression, Anxiety, and Stress Scale-21 Items); fear avoidance (Fear-Avoidance Beliefs Questionnaire); catastrophizing and coping (Pain-Related Self-Symptoms Scale); and self-efficacy (Pain Self-Efficacy Questionnaire). Psychological risk profiles were compared between movement-based subgroups within each scheme. RESULTS Scores across all questionnaires revealed that most patients had low psychological risk profiles, but there were instances of higher (range, 1%-25%) risk profiles within questionnaire components. The small proportion of individuals with higher psychological risk scores were distributed between subgroups across TBC, MDT, and OSC schemes. CONCLUSIONS Movement-based subgrouping alone cannot inform on individuals with higher psychological risk features.
3.
Association of obesity with chronic disease and musculoskeletal factors.
Minghelli, B, Oliveira, R, Nunes, C
Revista da Associacao Medica Brasileira (1992). 2015;(4):347-54
Abstract
INTRODUCTION overweight and obesity in adolescents are major public health problems with particular interest, because of their potential association with risk factors for development of diseases. The study aimed to determine the prevalence of overweight and obesity in adolescents in southern Portugal and investigate the association with risk factors for development of cardiovascular, respiratory and musculoskeletal diseases. METHODS the sample consisted of 966 adolescents aged 10 to 16 years. The calculation of body mass index (BMI), evaluation of blood glucose, total cholesterol and triglycerides, blood pressure, spirometry and application of low back pain (LBP) questionnaire were performed. RESULTS 178 (18.4%) adolescents were overweight and 52 (5.4%) obese. None of the variables revealed a statistically significant association with overweight and obesity. The presence of high blood pressure was observed in 200 (20.7%) individuals and hypertension in 158 (16.4%) adolescents. Overweight and obese adolescents are 2.3 times more likely to develop signs of pre-hypertension and hypertension. 559 (57.9%) students had restrictive respiratory disorders and 23 (2.4%) had obstructive disorders. Those who were overweight and obese had 0.64 probability of having restrictive respiratory disorders. CONCLUSION there was a high prevalence of overweight and obesity in Portuguese adolescents and these showed a statistically significant relationship with the development of pre-hypertension and hypertension, and restrictive respiratory disorders.
4.
The binomial work-health in the transit of Curitiba city.
Tokars, E, Moro, AR, Cruz, RM
Work (Reading, Mass.). 2012;:2991-7
Abstract
The working activity in traffic of the big cities complex interacts with the environment is often in unsafe and unhealthy imbalance favoring the binomial work - health. The aim of this paper was to analyze the relationship between work and health of taxi drivers in Curitiba, Brazil. This cross-sectional observational study with 206 individuals used a questionnaire on the organization's profile and perception of the environment and direct observation of work. It was found that the majority are male, aged between 26 and 49 years and has a high school degree. They are sedentary, like making a journey from 8 to 12 hours. They consider a stressful profession, related low back pain and are concerned about safety and accidents. 40% are smokers and consume alcoholic drink and 65% do not have or do not use devices of comfort. Risk factors present in the daily taxi constraints cause physical, cognitive and organizational and can affect your performance. It is concluded that the taxi drivers must change the unhealthy lifestyle, requiring a more efficient management of government authorities for this work is healthy and safe for all involved.