Lower Body Pain Research Articles

Better diet quality is associated with reduced body pain in adults regardless of adiposity: Findings from the Whyalla Intergenerational Study of Health

Dietary intake has been associated with pain and physical function, but it is unclear if these relationships are mediated by adiposity. Data were derived from the Whyalla Intergenerational Study of Health (n = 654, 57% women). Structural equation modelling tested the hypotheses that adiposity (body mass index (BMI), waist circumference (WC), or body fat (BF, dual energy x-ray absorptiometry)) would mediate the relationship between diet quality (Dietary Guideline Index (DGI) total, core, or non-core scores) and pain (Short Form-36 bodily pain scale (SF36-BPS)), or physical function (grip-strength), overall, and by gender. Adiposity did not mediate a relationship between DGI scores and pain. Direct effects were observed between DGI total scores and SF36-BPS accounting for BMI (β = 0.170, 95% CI 0.002, 0.339), and between DGI core food scores and SF36-BPS (BMI, β = 0.278, 95% CI 0.070, 0.486; WC, β = 0.266, 95% CI 0.058, 0.474; BF, β = 0.266, 95% CI 0.060, 0.473). In women, direct effects existed between DGI scores and SF36-BPS (DGI total scores, BMI, β = 0.388, 95% CI 0.162, 0.613; WC, β = 0.372, 95% CI 0.146, 0.598; BF, β = 0.382, 95% CI 0.158, 0.605, and DGI core scores, BMI, β = 0.482, 95% CI 0.208, 0.757; WC, β = 0.472, 95% CI 0.197, 0.747; BF, β = 0.467, 95% CI 0.195, 0.739), and DGI total scores and grip-strength (BMI, β = 0.075, 95% CI 0.008, 0.142; WC, β = 0.076, 95% CI 0.009, 0.143; BF, β = 0.079, 95% CI 0.011, 0.146). Better diet quality is associated with lower bodily pain, irrespective of adiposity. Findings highlight the potential role of diet quality in pain management and function, particularly in women.

Role of ureteral stent material and coating to prevent ureteral stent related issue: A systematic review and meta analysis.

Ureteral stents require materials that balance bulk and surface properties. Achieving both can be challenging, as ideal bulk properties may not align with optimal surface properties. Thus, researching coatings and biomanufacturing methods for ideal materials is essential. A systematic review and meta-analysis, following PRISMA Guidelines, involved literature searches across five databases: PubMed, Scopus, Embase, ClinicalKey, and Cochrane. From 417 screened articles, eight studies were deemed eligible for qualitative and quantitative analysis. The selected articles underwent bias assessment using ROB Tools 2. The systematic review analyzed 1.356 participants. Findings revealed that firm ureteral stents significantly increased risk of infection, hematuria, and lower body pain. On the contrary, soft stents reduced infection (OR: 0.62; p=0.004), hematuria (OR: 0.60; p<0.001), and lower body pain (OR: 0.63; p=0.0002). However, infection reduction effect was uncertain due to heterogeneity. Coated vs non-coated material analysis found no difference in encrustation (OR: 1.26; p=0.52) or infection (OR: 1.67; p=0.99). Stent firmness did not affect encrustation on double J stent (OR: 0.97; p=0.17). Softer materials like silicone are preferred for ureteral stents to reduce symptoms like hematuria and lower body pain. Coatings like silver nanoparticles and triclosan, while enhancing antimicrobial properties, did not effectively lower infection risk.

Mediterranean Diet Adherence and Health-Related Quality of Life during Pregnancy: Is the Mediterranean Diet Beneficial in Non-Mediterranean Countries?

This study aimed to examine the association of Mediterranean diet (MD) adherence and MD components with health-related quality of life (HRQoL) in pregnant women from Spain and Sweden. A total of 138 pregnant women from Spain (age: 32.9 ± 4.6 years old) and 302 pregnant women from Sweden (age: 31.3 ± 4.1 years old) were included. MD adherence was assessed with the Mediterranean food pattern (i.e., a MD index) at the 14-16th gestational weeks. HRQoL was assessed with the Spanish and Swedish versions of the 36-item Short-Form Health Survey (SF-36 and RAND-36, respectively) at the 14-16th and 34-37th gestational weeks. A greater MD adherence was associated with better physical functioning, bodily pain, vitality, emotional role, and mental health in cross-sectional associations (2nd trimester) in the Spanish sample (all p < 0.05). Furthermore, a greater MD adherence was associated with lower bodily pain in both Spanish and Swedish samples (both p < 0.05) in the 3rd trimester. The associations of MD adherence with pain seem to be explained by a greater intake of fiber, fish, fruits, nuts, and legumes (all p < 0.05). A greater MD adherence, driven by a higher intake of fiber, fish, fruits, nuts, and legumes, was associated with lower pain throughout pregnancy in both Mediterranean and non-Mediterranean populations.

The Prevalence of the Burnout Syndrome and Factors Associated in the Students of Dentistry in Integral Clinic: A Cross-Sectional Study.

Burnout syndrome (BS) is composed of three interrelated dimensions (emotional exhaustion, depersonalization, and personal fulfillment), and it has been documented that it affects health professionals from an early age. Determine the prevalence of BS and associated factors in the integral clinic of the Dentistry Pilot School. Material and Methods. Two instruments were applied: (1) Maslach Burnout Inventory, which measures the degree of professional burnout through 22 items that describe the professional's attitudes and feelings toward work, as well as symptoms associated with this phenomenon; (2) the second questionnaire determines the possible symptoms of BS and consists of 14 questions that describe tiredness, sleep problems, digestive problems, respiratory problems and headaches, temporomandibular joint (TMJ), neck pain, back pain, and upper and lower extremity pain. The instruments were answered anonymously by a total of 300 students who participated in the study. The emotional exhaustion of the participants was 48.3% at a higher level, the depersonalization was 46.7% at a higher level, and the low perception of personal fulfillment was 73%. In addition, it was shown that BS is significantly related to marital status (p < 0.001∗), with single people reporting being more exhausted, with the 6-month level (p = 0.011) and with the following symptoms: non-neck pain, head, TMJ, back, waist, upper and lower body pain. It was found that the BS had a prevalence of high levels of exhaustion and depersonalization correlated with the marital status and level of preparation (academic degree) of the person, finding a prevalence of symptoms such as pain in the neck, head, TMJ, and back.

0118 Association between TNF-α G308A Polymorphism (rs1800629) and Insomnia Vulnerability in Fertile Age Women with Primary Dysmenorrhea

Abstract Introduction Higher tumor necrosis factor-alpha (TNF-α) gene expression has been revealed in the peripheral blood monocytes across the menstrual cycle in patients with primary dysmenorrhea (PDM) than in the unaffected control. Sleep quality is affected by environmental factors, endocrine function abnormalities and genetic factors. The aim of this study was to evaluate the effect of TNF-α G308A polymorphism (rs1800629) on the self-reported sleep, health, menstrual pain severity as well as peri-ovulatory serum TNF-α level in women with and without PDM. Methods Sleep, psychological and physiological characteristics and menstrual pain severity were collected with questionnaires and sleep/menstrual diary within a menstrual cycle from a cohort of 43 PDM women and 42 healthy controls (aged 20-30 years, right-handed, non-smoking and non-shift workers without psychiatric, sleep and neurological comorbidity). Chi-square tests were used to check if the genotype proportions of the investigated gene fitted the Hardy-Weinberg equilibrium (HWE) and to evaluate if the genotypic and allelic distribution is associated with PDM. Chi-square tests or analysis of variance were used to examine the effects of genotype, group and/or genotype x group interaction with the sleep, mind and the body health variables. Results Neither allele frequencies nor genotypes of TNF-α G-308A gene could serve as an independent risk factor of PDM in the Taiwanese population. Circulating serum TNF-α did not correspond with the -308 TNF-α promoter polymorphism, either, which might be due to a multifactorial control process. The TNF-α 308 A allele carriers (28.6%) which was less common than the G allele carriers (71.4%), showed lower Beck depression score, lower bodily pain and better physical health and higher subjective sleep quality. Furthermore, in G allele carriers, the PDM group showed higher insomnia severity and lower sleep duration than that of the control group. Conclusion Present results suggested that TNF-alpha polymorphism conferred no prediction to PDM risk and peri-ovulatory serum TNF-α level. However, our findings were evident that the A allele at the TNFα 308 locus, as compared to the more common G allele, was associated to better health and better sleep, with an indication of a genetic underpinning to their better resistance from the risk of PDM. Support (if any)

Gymnastics Training Consequences: Possibility of Upper and Lower Body Pain

In gymnastics, injury is one of the causes of not achieving training goals. This is likely to happen to athletes, instructors, and participants in general. The severity type of the injury is determined by the type of gymnastic activity performed. This study aimed to examine the potential for injury or pain that can occur in the upper body and lower body, before and after exercise. This research was conducted using a descriptive research design, which involved a population sample of 108 Indonesian female gymnastics athletes. Data were obtained through observation and questionnaires regarding the condition of the athletes before and after participating in the exercise. The results showed that the most pain occurred in the upper body area (shoulder, back and waist), while the lower body parts where the injury commonly emerged were the hips, hamstrings, and the hollow of the legs. It is also possible that the injury came up long after the exercise. From the observation data, the highest incidence of pain in the upper body is in the waist (34 people) and the least is in the shoulders. While in the lower body, the most pain complaints occurred in the pelvis (30 people) and the least occurred in the thighs (5 people). Thus, it can be concluded that the potential for injury due to movement activities in gymnastics has different proportions for each location. Based on these findings, to avoid the negative impact of these injuries, it is necessary to carry out strengthening exercises in areas that are prone to experiencing pain or injury.

Unilateral Modified Posterior Lumbar Interbody Fusion Combined With Contralateral Lamina Fenestration Treating Severe Lumbarspinal Stenosis: A Retrospective Clinical Study.

Study design: Retrospective study. Objectives: The traditional PLIF is routinely utilized in severe lumbar spinal stenosis to relief the nerve compression. Nevertheless, the removal of posterior tension-band structure and the denervation and atrophy of the paraspinal muscle affect the clinical efficacy. Therefore, unilateral modified PLIF combined with contralateral fenestration was performed to overcome above-mentioned drawbacks. Methods: 32 modified PLIF and 33 traditional PLIF cases were retrospectively included. Operation time, length of stay (LOS) and blood loss were recorded. VAS of low back pain and leg pain, ODI and Sf-36 score including physical function and body pain were assessed. Fusion rate, lumbar lordosis (LL), intervertebral angle (IVA) and intervertebral height index (IHI) were evaluated radiologically. Results: Modified group possessed less blood loss, shorter operation time and less LOS. Compared with traditional group, the VAS of back pain was lower at 6months postoperatively (P < .05) and the ODI score was lower at 3months postoperatively (P < .05) in modified group. Modified group exhibited better physical function 3months postoperatively and lower body pain 6months postoperatively in Sf-36 score (P < .05). No statistic difference in LL, IVA, IHI and fusion rate were observed between both groups. Conclusions: Our modified PLIF combining with contralateral fenestration procedure exhibited particular advantages in comparison to traditional PLIF. The preservation of posterior tension-band structure facilitates to less low back pain, low complication rate and early functional recovery.

The characteristics of the young patients with cervical ossification of the posterior longitudinal ligament of the spine: A multicenter cross-sectional study

BackgroundOssification of the posterior longitudinal ligament of the spine (OPLL) is characterized by heterotopic bone formation in the posterior longitudinal ligament of the spine. Although the patients with OPLL are more common in the 60s and 70s, we know that there are markedly young patients (e.g., early 40s). However, to the best of our knowledge, there is few reports characterize young patients with cervical OPLL in terms of the imaging features, subjective symptoms, and ADL problems. MethodsThis is the multicenter cross-sectional study. Two hundred and thirty-seven Japanese symptomatic patients with cervical OPLL confirmed by standard X-rays collected from 16 institutions belonging to the Japanese Multicenter Research Organization for Ossification of the Spinal Ligament formed by the Japanese Ministry of Health, Labor and Welfare were recruited. Whole spine CT data as well as demographic data such as age, gender, patients-based evaluations, and the 36-item Short Form Health Survey (SF-36) were evaluated. ResultsYoung group (≦ 45 years old) consisted of 23 patients (8 females and 15 males), accounting for 9.7% of the total. Their characteristics were high body mass index (BMI), significant involvement of trauma in the onset and deterioration of symptoms, and the predominance of thoracic OPLL. The patient-based evaluations did not show a significant difference between the young and non-young groups, or between the genders in the young group except for bodily pain (BP) of SF-36. Female patients in young group had significantly lower BP score of SF-36 than that of male in young group. ConclusionsCharacteristics of young patients with cervical OPLL were high BMI, significant involvement of trauma in the onset and deterioration of symptoms, lower BP score of SF-36 in female, and the predominance of thoracic OPLL.

Health quality of retired Royal New Zealand Navy personnel: A cross-sectional analysis

Purpose: To characterise the current health quality of retired Royal New Zealand Navy (RNZN) personnel. Methods: A Cross-sectional analysis of self-reported survey data was conducted. A total of 300 retired RNZN personnel completed a Health-Related Quality of Life (HRQOL) survey on-line using the SF-36v2 to assess physical and mental health domains. The Physical Component Summary [PCS] combined Physical Function (PF), Role Physical (RP), Bodily Pain (BP) and General Health (GH) subscales. The Mental Component Summary [MCS] combined Vitality (VT), Social Functioning (SF), Role Emotional (RE) and Mental Health (MH) subscales. Analysis by age, gender, ethnicity, and rank were conducted for the subscale results. Comparisons of the RNZN cohort with the 1998 US National and New Zealand 2006-2007 health surveys were made. Results: New Zealand Europeans (NZE) recorded a higher mean RP and PCS than New Zealand Māori (NZM) (RP: 66.9 vs. 54.9; t(46)=-2.2; p=0.0294; d=0.50; PCS: 68.9 vs. 65.7; t(46)=-2.3; p=0.0267; d=0.47). Senior Rates recorded a higher MH (69.5 vs. 66.2; t(19)=-1.1; p=0.0568; d=0.35) but a lower PCS (65.0 vs. 65.6; t(19)=0.6;p=0.0681 d=0.07) and MCS (59.2 vs. 59.4; t(19)=-1.4; p=0.0865; d=0.46) than Officers. Compared with the New Zealand 2006-2007 health survey, the retired RNZN cohort had a lower RP (58.0 vs. 85.7; d=1.14), BP (42.6 vs. 75.3; d=1.51), SF (59.8 vs. 88.4; d=1.85) and MH (68.5 vs. 82.3; d=1.28). Conclusion: The lower HRQOL subscales results (especially BP) for retired RNZN personnel compared to the general population and other service personnel indicates a need for more research to understand the potential reasons for these findings. The effects of the lifestyle and training requirements combined with the entry selection of healthy people into the navy may have impacted on the results reported in this survey.

Drawing the borderline: Predicting treatment outcomes in patients with borderline personality disorder

BackgroundA routinely collected big data set was analyzed to determine the effectiveness of naturalistic inpatient treatment and to identify predictors of treatment outcome and discontinuation. MethodsThe sample included 878 patients with borderline personality disorder who received non-manualized dialectic behavioral therapy in a psychosomatic clinic. Effect sizes (Hedge's g) were calculated to determine effectiveness. A bootstrap-enhanced regularized regression with 91 potential predictors was used to identify stable predictors of residualized symptom- and functional change and treatment discontinuation. Results were validated in a holdout sample and repeated cross validation. ResultsEffect sizes were small to medium (g = 0.28-0.51). Positive symptom-related outcome was predicted by low affect regulation skills and no previous outpatient psychotherapy. Lower age, absence of work disability, high emotional and physical role limitations and low bodily pain were associated with greater improvement in functional outcome. Higher education and comorbid recurrent depressive disorder were the main predictors of treatment completion. The predictive quality of the models varied, with the best being found for symptom-related outcome (R2 = 18%). ConclusionWhile the exploratory process of variable selection replicates previous findings, the validation results suggest that tailoring treatment to the individual patient might not be based solely on sociodemographic, clinical and psychological baseline data.

International Fitness Scale-IFIS: Validity and association with health-related quality of life in pregnant women.

This study aimed (a) to examine the construct validity of the International Fitness Scale (IFIS) to discriminate between different objectively measured physical fitness levels in pregnant women and (b) to assess the extent to which IFIS is able to discriminate between pregnant women with different levels of health-related quality of life (HRQoL). A total of 159 pregnant women were involved in the GESTAtion and FITness project: 106 pregnant women (mean age 32.7, SD 4.4years) were included. Self-reported physical fitness-that is, cardiorespiratory fitness, muscular strength, flexibility, and overall fitness-was assessed with the IFIS. Physical fitness was objectively measured using the Bruce test, the handgrip strength test and the back-scratch test. The HRQoL was assessed with the 36-item Short Form Health Survey (SF-36). Higher self-reported physical fitness measured with IFIS was associated with higher objectively measured physical fitness (P<.05). There was a linear association so that higher self-reported physical fitness (ie, IFIS; regardless of the fitness component) was related to greater General Health dimension scores (P<.05). Moreover, higher self-reported physical fitness (all components except muscular strength) was associated with better Physical Functioning, lower Bodily Pain and higher Vitality scores (ie, SF-36 components). This linear trend was not seen for objectively measured physical fitness. The results of this study suggest that IFIS might be a useful tool for identifying pregnant women with low or very low physical fitness and with low quality of life health-related. Further research should elucidate whether IFIS can identify women with pregnancy complications before it can be implemented in clinical practice.

Relationship between pre-sarcopenia and quality of life in patients with chronic liver disease: a cross-sectional study.

This study aimed to clarify the relationship between pre-sarcopenia (PS) and quality of life (QOL) in patients with chronic liver disease (CLD). This cross-sectional study evaluated 335 patients with CLD. PS was diagnosed on the basis of the assessment criteria by the Japan Society of Hepatology. QOL was evaluated using the short form-36. Patients' mean age was 69.52 ± 10.17 years, and 169 (50.4%) participants were men. The prevalence of PS was 53.7%. Patients were divided into the PS and non-pre-sarcopenia (NPS) groups. Patients in the PS group were older (71.84 ± 9.78 vs. 66.81 ± 9.97, P < 0.01) and mostly women (65.2 vs. 37.8%, P < 0.01) compared with those in the NPS group. QOL, physical function (38.30 ± 17.63 vs. 44.02 ± 14.76, P < 0.01), physical role functioning (RP) (40.63 ± 15.38 vs. 44.88 ± 13.89, P < 0.01), and bodily pain (BP) (48.42 ± 11.45 vs. 51.24 ± 10.19, P = 0.02) were significantly lower in the PS group than in the NPS group. Logistic regression analyses identified that the independent predictive factors for PS were female sex (odds ratio: 3.16, 95% confidence interval: 2.01-4.98; P < 0.01) and RP (odds ratio: 1.97, 95% confidence interval: 1.24-3.12; P < 0.01). QOL characteristics of PS patients with CLD were low physical function, RP, and BP in short form-36. In addition, social role functioning was low in the PS patients aged 65-74 years, whereas RP and BP were low in those aged at least 75 years. Female sex and RP were independent predictors of PS according to the multivariate analysis. Maintaining and increasing muscle mass in patients with CLD may contribute toward improving physical QOL.

Study of comfort performance of novel car seat design for long drive

Back pain is a commonly known problem for drivers and passengers traveling in long route vehicles, especially buses and trucks. The problem becomes more severe for people suffering from bedsores. The current embodiment is a step toward addressing this problem. This method helps to regulate blood flow and provide comfort to the drivers and bedsore patients. Pneumatic cylinder and 24 semi-circular designed aluminum buds are used in the assembly that moves up and down along with the comforter foam and sheet to serve the purpose. This design is an active way of providing comfort and has significantly helped in reducing back and lower body pain. A survey was conducted by 100 participants to analyze the comfort of the current embodiment. The age of these participants was divided into two categories. Results showed that comfort varies with age and pressure. It was concluded from the survey that young people from 20 to 30 years appreciate high pressure, whereas elderly people from 30 to 50 years like low pressure. The results from analysis of variance were found to be significant with feedback results. This system is also helpful in regulating blood flow. It was concluded that most people like high pressure and the first pattern.

Alexithymia and Quality of Life in Adult Patients with Juvenile Idiopathic Arthritis

Patients with chronic pain disturb not only quality of life (QL) but also develop difficulties in describing their feelings. Prolonged pain, stress, pathological conditions and related emotions can alter the perceived sensation of pain. The aim of our study was to study the QL and the level of alexithymia in adult patients with different types of juvenile idiopathic arthritis (JIA).Materials and methods. 173 young people aged 18-40 years old were examined: 118 adult patients with different ILAR variants of JIA, 30 patients with ankylosing spondylitis (AS) and 25 healthy young people. The QL was assessed using the Short-Form-36 questionnaire (SF36) with further assessing the level of alexithymia by Toronto alexithymia scale (TAS-20).Results. The analysis of QL shows that PCS (44.8±9.9) was significantly lower (p=0.001) in patients with JIA than in healthy subjects (55.7±6.9) of the corresponding age and sex, but did not differ from patients with AS (42.3±7.5). Patients with JIA had lower physical (p=0.001), role functioning (p=0.001) and bodily pain (p=0.001) compared with healthy, with no difference from patients with AS. In the distribution of patients with JIA in groups by the level of alexithymia, differences in QL were not revealed by MCS or PCS and scales related with them. The relationship analysis between the alexithymia and QL in patients with JIA shows, that elevated and high levels of alexithymia were related with low levels of MCS (p&lt;0.05), role functioning (p&lt;0.05), mental health (p&lt;0.05). PCS and physical functioning did not affect the level of alexithymia in adult patients with JIA. PCS, role functioning, bodily pain, and general health were the lowest in patients with poly-articular JIA. However patients with oligo-, poly-articular, enthesyte-related JIA had no differences on scales related to PCS. Patients with poly-JIA with elevated and high levels of alexithymia revealed significantly lower social (p&lt;0.05) and role (p&lt;0.05) functioning, mental health (p&lt;0.05) compared to patients without alexithymia. The presence of low bodily pain in alexithymic patients was found. Signs of alexithymia were found in 90% and 85% of adult patients with the oligo-arthritis and enthesyte-related JIA, respectively. The comparison of the QL in patients with oligo-arthritis and enthesitis-related JIA with different levels of the alexithymia shows no significant differences.Conclusions. 85.2% of adult patients with different variants of JIA have elevated and high levels of alexithymia. Adult patients with JIA have lower physical functioning than healthy individuals of the same age and sex, although they do not differ from the control group and AS group on psychological functioning and related vitality, social and role functioning, and mental health. The presence of alexithymia is related with a low level of psychological functioning, role functioning, mental health. However, physical functioning did not affect the level of alexithymia in adult patients with JIA. Patients with poly-JIA have the lowest physical, role function, bodily pain and general health, but according to the psychological functioning there were no differences between different variants of JIA in adulthood. Patients with poly-JIA with elevated and high levels of alexithymia have significantly lower social (p&lt;0.05), role (p&lt;0.05) functioning and mental health (p&lt;0.05) compared to patients without signs of alexithymia.

PSY17 - Evaluation of Opioid use Among Patients with Back Disorders and Arthritis

This retrospective cohort study evaluated the impact of opioid use in back pain and arthritis on health-related quality of life (HRQoL). Using data from the Medical Expenditure Panel Survey, participants must have back pain or arthritis for three of the five rounds, have no opioid use in Round 1 of the survey, and be cancer-free. Opioid use was evaluated in Rounds 2-4. Outcome measures, assessed in Round 4, were HRQoL [represented by the Mental Component Score (MCS) and the Physical Component Score (PCS)] and subdomains of MCS [Vitality (VT), Social Functioning (SF), Role Emotional (RE), and Overall Mental Health (MH)] and PCS [Bodily Pain (BP), Physical Functioning (PF), Role Functioning (RF), and General Overall Health (GH)]. Estimated propensity for opioid use was used in a 1:1 Greedy match. Linear regressions were used to analyze outcomes after matching. 1,871 eligible participants (690 opioid and 1,181 non-opioid users) were identified. MCS was not different between opioid and non-opioid users. PCS and BP were significantly lower among opioid users versus non-opioid users (PCS: β=-2.26, 95%CI: -4.16 to -0.37, p=0.0194; BP: β=-2.72, 95%CI: -4.72 to -0.72, p=0.0077). MCS and RE subdomain were significantly higher among short-term opioid user (<1 month) compared to non-opioid users (MCS: β=2.71, 95%CI: 0.65 to 4.76, p=0.0099; RE: β=3.44, 95%CI: 1.25 to 5.63, p=0.0021). PCS and its subdomains trended towards improvement with short-term use. Long-term users (≥1 month) had significantly lower SF, PCS, BP, PF, RF, and GH scores compared to non-opioid users. Low-dose opioid users had lower PCS, BP, and RF scores as compared to non-opioid users, although most differences never reached clinical significance. No difference in HRQoL was found between high-dose users and non-opioid users. Opioid use, and particularly long-term opioid use, in those with back pain and arthritis is not associated with improved HRQoL.

Functional disability associated with disease and quality-of-life parameters in Chinese patients with rheumatoid arthritis

BackgroundAs an important outcome measure among rheumatoid arthritis (RA) patients, functional disability may contribute to unemployment, loss of work productivity, and impaired quality of life. However, little is known about the risk factors of functional disability in Chinese RA patients. This study aimed (1) to examine the prevalence of functional disability in Chinese RA patients; (2) to explore factors associated with the health assessment questionnaire-disability index (HAQ-DI).MethodsA total of 101 RA patients in this cross-sectional study underwent standardized laboratory examinations and responded to the questionnaire for demographic data, the HAQ-DI for functional disability, the Compliance Questionnaire on Rheumatology (CQR) for medication adherence, the Hospital Anxiety and Depression Scale (HADS) for psychological status, and the Short Form 36 health survey (SF-36) for quality of life. Pain, grip/pinch strength, disease activity, and large joint mobility were recorded. Independent samples t-tests, chi-square analyses, and logistic regression modeling were used to analyze the data.ResultsThe mean ± SD age of RA patients was 54.9 ± 11.9 years. Approximately 15.8% RA patients in mainland China experience functional disability (defined as a HAQ-DI score ≥ 1). Long disease duration, pain, high disease activity, a larger number of tender and swollen joints, high C-reactive protein (CRP) level, decreased grip strength, and limitation of shoulder, elbow, wrist, knee, and ankle motion were associated with the HAQ-DI. Participants with functional disability tended to have more severe depressive symptoms and a lower quality of life compared with individuals without functional disability. Stepwise logistic regression analyses found that limitation of wrist extension (P = 0.001) and lower body pain (BP) score (P = 0.001) explained higher HAQ-DI score.ConclusionsThe present study reported that functional disability was common in Chinese RA patients. A low quality of life and limitation of joint mobility had great impacts on functional disability in Chinese RA patients. Targeted and culturally sensitive interventions should be strengthened to delay the onset of disabilities of this population.

Sickness absence and permanent work disability in relation to upper- and lower-body pain and occupational mechanical and psychosocial exposures.

The aim of this study was to examine if combined pain (pain in the upper and lower body), high occupational mechanical exposures, and job strain predict sickness absence and permanent work disability, particularly if co-occurring. This longitudinal study was based on the musculoskeletal research database at the Danish Ramazzini Centre. We linked baseline information from 2001-2004 on musculoskeletal pain, job titles, and covariates with register information on sickness absence and permanent work disability. Mechanical and psychosocial exposure estimates were obtained from job exposure matrices. We used multivariable Cox regression. The study included 25 292 persons. Compared to low occupational mechanical exposures and no pain, low mechanical exposures and combined pain showed an adjusted hazard ratio (HR adj) of 1.81 [95% confidence interval (95% CI) 1.58-2.08], while high mechanical exposures and combined pain showed HR adj3.71 (95% CI 3.24-4.25) for sickness absence. The corresponding values for permanent work disability were 3.35 (95% CI 1.74-6.45) and 4.59 (95% CI 2.36-8.94). Job strain showed an association with sickness absence [HR adj1.24 (95% CI 1.10-1.39)], while low social support was associated with both sickness absence and permanent work disability [HR adj1.30 (95% CI 1.19-1.41) and 2.19 (95% CI 1.41-3.41), respectively]. Combined pain in the upper and lower body was associated with sickness absence and permanent work disability, and high occupational mechanical exposures further increased the risk. Job strain showed a modest association with sickness absence, while low social support at work was associated with both outcomes, especially permanent work disability.

Prevalence of sexual dysfunction after risk-reducing salpingo-oophorectomy

ObjectivesTo determine the prevalence of sexual dysfunction in women after risk-reducing salpingo-oophorectomy (RRSO) and to assess factors which may influence sexual wellbeing following this procedure. MethodsThis work is a cross-sectional study of women who underwent RRSO at a tertiary gynecologic oncology unit between January 2009 and October 2014. Data collection involved a comprehensive questionnaire including validated measures of sexual function, sexual distress, relationship satisfaction, body image, impact of event, menopause specific quality of life, and general quality of life. Participants were invited to undergo blood testing for serum testosterone and free androgen index (FAI). Results119 of the 206 eligible women participated (58%), with a mean age of 52years. The prevalence of female sexual dysfunction (FSD) was 74% and the prevalence of hypoactive sexual desire disorder (HSDD) was 73%. Common sexual issues experienced included; lubrication difficulty (44%), reduced sexual satisfaction (41%), dyspareunia (28%) and orgasm difficulty (25%). Relationship satisfaction, the use of topical vaginal estrogen and lower generalized body pain were significantly associated with a decreased likelihood of sexual dysfunction. Serum testosterone, FAI, the use of systemic hormone replacement therapy (HRT), prior history of breast cancer, menopausal status at the time of surgery and hysterectomy did not correlate with sexual dysfunction. ConclusionThe prevalence of FSD and HSDD after RRSO was 74% and 73% respectively. Relationship satisfaction, low bodily pain and use of topical vaginal estrogen were associated with a lower likelihood of sexual dysfunction. There was no correlation between serum testosterone or FAI, and sexual dysfunction.

AB1153-HPR Associates of Quality of Life in Patients with Systemic Lupus Erythematosus

BackgroundHealth-related quality of life (HRQoL) represents patient's overall perception of the illness, symptoms severity and treatment impact on physical, emotional and social functions, and became an important complementary source of...

Improvement in health‐related quality of life with recombinant factor IX prophylaxis in severe or moderately severe haemophilia B patients: results from the BAX326 Pivotal Study

Little is known about the health-related quality of life (HRQoL) burden of haemophilia B. The aim of this study was to assess HRQoL burden of haemophilia B, the benefit of recombinant factor IX (rFIX) prophylaxis and the HRQoL benefit of achieving a zero annual bleed rate. Subjects receiving rFIX (BAX326) prophylaxis or on-demand completed the SF-36 survey. Baseline SF-36 scores were compared to the general US population scores to understand the HRQoL burden. Changes in SF-36 scores between baseline and follow-up were tested using t-tests. Subgroup analysis was conducted to examine SF-36 change among subjects who switched to BAX326 prophylaxis. SF-36 scores were also compared between those with zero bleeds and those who bled during the study. Compared to the US norms, subjects reported lower average scores in all physical and several mental HRQoL domains. At follow-up, prophylaxis subjects reported statistically significant and clinically meaningful improvements in overall physical HRQoL, as measured by the Physical Component Score (PCS) (mean change 2.60, P=0.019), Bodily Pain (BP) (3.45, P=0.015) and Role Physical (RP) domains (3.47, P=0.016). Subjects who switched to prophylaxis from intermittent prophylaxis or on-demand experienced more pronounced improvements not only in the PCS (3.21, P=0.014), BP (3.71, P=0.026), RP (4.43, P=0.008) but also in Vitality (3.71, P=0.04), Social Functioning (5.06, P=0.002) and General Health domains (3.40, P=0.009). Subjects achieving zero bleeds reported lower BP (P=0.038). Prophylaxis with BAX326 significantly improved HRQoL in patients with moderately severe or severe haemophilia B by reducing bleeds.