Low back pain (LBP), though non-life-threatening, burdens healthcare with treatment expenses and work hours lost. Globally, 70-84% experience it, with risk factors tied to societal structure, income, ...and living conditions, making it a leading cause of disability.
This study utilized data from the 2019 Türkiye Health Survey, which consisted of 17,084 individuals aged 15 and above. Our study focused on investigating the factors related to low back pain through a cross-sectional analysis. To analyze these factors, we employed binary multivariate logistic regression. Additionally, we conducted post-hoc analyses to assess the potential mediating effect of depressive symptoms on the relationship between low back pain and gender.
We found that 31.9% of the population experienced low back pain, with women being 58% more likely aOR = 1.58; 95% CI (1.45-1.73) than men to report symptoms. Individuals aged 55 + years old had a 90% aOR = 1.90; 95% CI (1.61-2.23) chance of experiencing low back pain, indicating an age-related increase. In the general population, having depressive symptoms was 2.49 95% CI (2.23-2.78) times more likely associated with low back pain. Our mediation analysis showed that gender (i.e., women vs. men), indicated by direct effects with β-estimates e = 0.78, predicted the likelihood of low back pain. Additionally, the relationship between gender and low back pain, mediated through a history of depressive symptoms, had a significant total indirect effect (i.e., β-estimate given as e = 0.49). Specifically, a history of depressive symptoms accounted for 17.86% 95% CI (9.67-20.10) of the association between women having a higher likelihood of low back pain compared to men.
We observed that a higher likelihood of low back pain associated with gender and aging. Additionally, BMI served as a significant predictor, particularly in adults. Depression mediated the association between gender and low back pain. Acknowledging these associations may help identify and address contributing factors to LBP, potentially increasing awareness and alleviating the burden. Policymakers and healthcare professionals may consider these findings when developing prevention and treatment programs for low back pain.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Over the past four decades, research has underscored the significance of approaching and preventing trauma from a systemic standpoint. Trauma-informed care (TIC) methodologies offer a structure for ...healthcare practices, striving to convert organizations into trauma-informed systems that employ trauma-specific interventions. This review employs epidemiological and household data from Turkey to underscore the importance of integrating trauma-informed care as a means of prevention and intervention. Through a desk review, the study examines the role of adverse childhood experiences (ACEs), delving into their origin from family dynamics, migration, violence, exposure to violence, juvenile delinquency, and child maltreatment. The research highlights innovative healthcare approaches that leverage data to address complex patient health issues while considering mental health needs. In contemporary times, healthcare organizations acknowledge the value of a data-driven approach to make informed clinical decisions, enhance treatment procedures, and improve overall healthcare outcomes. The reviewed research and empirical data furnish proof of the importance of effective and efficient treatment methods that prioritize trauma prevention and treatment, integrating the role of ACEs. This paper seeks to contribute to discussions on transforming the healthcare system to meet the healthcare needs of Turkish households, all the while taking into account the evolving sociopolitical factors that shape Turkey's population characteristics.
Depressive symptoms are associated with both long-lasting and short-term repetitive mood disorders and affect a person's ability to function and lead a rewarding life. In addition to predisposing ...genetic causes, other factors such as socioeconomic and demographic factors, and chronic diseases have also been reported to associate with depression. In this study, we analyzed the association between history of chronic diseases and presentation of depressive symptoms amongst Turkish individuals.
We employed the 2019 Turkey health survey to analyze data of 11,993 individuals aged 15+ years. Depressive symptoms were assessed using the eight-item Patient Health Questionnaire (PHQ-8) coded with a binary measure, a score of <10 as less depressed and >10 as moderate-severely depressed. A number of sociodemographic characteristics were adjusted for in the analyses. Logistic regression models were used to test the association between chronic diseases and depressive symptoms in the study sample.
Our analysis revealed that 6.24% of the 11,993 participants had reported an episode of depressive symptoms. The prevalence of depressive symptoms in men was 1.85% and in women, it was 2.34 times higher. Participants who had previously reported experiencing coronary heart diseases (AOR = 7.79, 95% CI 4.96-12.23), urinary incontinences (AOR = 7.90, 95% CI 4.93-12.66), and liver cirrhosis (AOR = 7.50, 95% CI 4.90-10.42) were approximately eight times likely to have depressive symptoms. Similarly, participants with Alzheimer's disease (AOR = 6.83, 95% CI 5.11-8.42), kidney problems (AOR = 6.63, 95% CI 4.05-10.85), and history of allergies (AOR = 6.35, 95% CI 4.28-9.23) had approximately seven-fold odds of reporting episodes of depressive symptoms. The odds of presenting with depressive symptoms amongst participants aged ≥ 50 were higher than in individuals aged ≤ 49 years.
At individual level, gender and general health status were associated with increased odds of depression. Furthermore, a history of any of the chronic diseases, irrespective of age, was a positive predictor of depression in our study population. Our findings could help to serve as a reference for monitoring depression amongst individuals with chronic conditions, planning health resources and developing preventive and screening strategies targeting those exposed to predisposing factors.
Antiretroviral treatment (ART) appropriately and regularly used decreases the human immunodeficiency virus (HIV) viral load in the bloodstream, preventing HIV-infected people from spreading the ...infection to others. Disparities in ART adoption persists in East and Southern Africa, with low HIV-positive status knowledge being the primary factor. We investigated individual and household characteristics of HIV-positive status awareness among adults with long-term HIV infection in four East and Southern African countries: Eswatini, Malawi, Tanzania, and Zimbabwe. The study analyzed data from surveys conducted in Eswatini, Malawi, Tanzania, and Zimbabwe in 2015–2016. Only individuals who tested positive for HIV through rapid tests were included in the analysis. Those who already knew they were HIV-positive were categorized as aware, while those who reported being negative, never tested, or didn’t know their status were categorized as unaware. Statistical models were used to examine various factors related to HIV awareness. Pooled and country-specific odds ratios were computed. The percentage of people who knew they had HIV ranged from 58% (Tanzania and Malawi) to 87% (Eswatini). After adjusting for other variables, young persons in all countries were less likely to be aware of their HIV-positive status. Gender, marital status, education, working status, household wealth, and urbanization level of households were also associated with HIV-positive status awareness but inconsistent across countries. HIV-positive status awareness in these four East and Southern African nations remained unsatisfactory as compared to the United Nations’ 95% guideline, indicating that testing and knowledge of HIV testing in this region still has a lot of potential for improvement. The observed variations among nations may be attributable to differences in HIV pandemic culture and policies. The findings of this study will assist governments determining which subpopulations to target to boost adoption of HIV testing services, as well as in designing and development of policies.
Objective: In recent years, synthetic cannabinoids (bonsai) poisoning is a widely seen case that needs to be treated in intensive care unit (ICU) in our country. In this study, it was aimed to ...discuss the clinical characteristics of patients diagnosed with synthetic cannabinoid intoxication followed in ICU. Material and Method: Patients followed in ICU of Çanakkale Onsekiz Mart University and Çanakkale State Hospital between 2014 and 2015 were studied retrospectively. Results: Twelve cases were included. In neurological system; confusions (n=4), drowsiness (n=7), restlessness/agitations (n=5), hallucinations (n=2), anxieties/panics (n=3), acute psychosis (n=1) and amnesias (n=11) were detected. One patient was intubated. In cardiovascular system; tachycardias (n=3), bradycardias (n=2), hypertensions (n=2), hypotension (n=1), and arrhythmias (n=2) were observed. In laboratory tests, leukocytosis (n=4), leukopenia (n=1), hypoglycemias (n=3), elevation in liver and renal function tests (n=1) were identified. The average recovery time was 19.3-hours and the average ICU stay was 3-days. Conclusion: In the synthetic cannabinoid intoxication cases; it should be kept in mind that seizure activities may occur in the first hours, myocardial infarction risk in the first 3-days. Liver-kidney functions should be monitored. Hypopotasemia is the most common electrolyte disorder. Cases without any complication are expected to recover in 24-hours. However, new types of synthetic cannabinoids are put on the market every day.
Introduction:The incidence of hypotension in cesarean section operations performed with spinal anesthesia varies between 55-90%. In this study, the relationship between the patient's abdominal ...circumference, symphyseal fundal height, and vertebral column length with the incidence of hypotension and the level of block in cesarean section operations performed under spinal anesthesia was investigated. Methods: The prospective, single-center study was conducted with patients who had undergone cesarean section with spinal anesthesia at the Training and Research Hospital. Pregnant and ASA II group patients older than 37 weeks who were to undergo cesarean section with spinal anesthesia were included in the study Patients with multiple pregnancies, patients with premature rupture of membranes, preterm patients, and patients in active labor were excluded from the study Those with diagnoses of abnormal presentation, polyhydramnios, oligohydramnios, macrosomic babies, and intrauterine growth retardation were also excluded from the study Abdominal circumference was measured at the umbilicus level at the end of expiration in the supine position. Vertebral column length was measured and recorded from the C7 vertebra to the sacral hiatus. The distance of the patient from the symphysis pubis to the highest point of the uterine fundus in the supine position was measured and recorded. Spinal anesthesia was performed in the sitting position with a 26G Quincke spinal needle for the first time through the L4-5 interval and 2 mL of 0.5% hyperbaric bupivacaine was administered. When the block reached T6, the operation was started. Electrocardiogram (ECG), SpO.sub.2, and arterial blood pressure were monitored, and the first values were recorded. Results: A total of 98 parturient patients were included in this study Overall, the incidence of hypotension was 87.78% (87 out of 98 parturients). Symphyseal fundal height correlated positively with spinal blockade levels at each different time point except for "Min. 4". Discussion and Conclusion: Symphyseal fundal height is a sensitive marker to determine the risk of hypotension after spinal anesthesia. We found that the symphyseal fundal height is a more sensitive marker for hypotension that will develop after spinal anesthesia compared to the other two parameters. Keywords: Abdominal circumference; hypotension; spinal anesthesia; symphyseal fundal height; vertebral column length.
The aim of this study is to assess the acceptability of following three different fasting protocols Early Time-restricted Feeding (eTRF; eating majority of kcals before 5pm), Time-restricted Feeding ...(TRF; restricting feeding window to 8 h/d), or Alternate Day Fasting (ADF; complete fasting every other day).
In this remotely delivered six-week crossover intervention, participants were randomly assigned to follow either an eTRF, TRF, or ADF diet for one week, followed by a one-week washout period. Participants followed all three diets and completed questionnaires assessing self-reported weight, energy intake, dietary acceptability (Food Acceptability Questionnaire), and facilitators and barriers to adhering to each diet. Differences in main outcomes (e.g., dietary acceptability and weight loss) were assessed via repeated measures ANOVA.
A total of 32 of participants began the study (mean BMI of 32.6 ± 6.0 kg/m2). There were no differences in kcals or weight loss among the three diets. Dietary acceptability was higher on the TRF diet (54.1 ± 8.2) than the eTRF (50.2 ± 6.6, p = 0.02) or ADF (48.0 ± 7.9, p = 0.004) diets. The majority of participants (71%) indicated the TRF diet was the easiest to follow and 75% said that ADF was the most difficult. Participants cited having a mobile app to track their diet and being provided with menu plans would help facilitate adherence with their diets.
This study found that acceptability was highest for an TRF diet and lowest for ADF, with no differences in weight loss or change in energy intake among the TRF, ADF, or eTRF groups.
NCT04527952.
The aim of the present study was to investigate the effects of perioperative undesirable hypothermia on inflammatory (interleukin (IL)-8, IL-10, IL-18, IL-23 and pentraxin (PTX)-3) and metabolic ...responses (cortisol and insulin) and recovery time.
A total of 60 patients between the ages of 18 and 65 years who were in the lumbar stabilisation operation were included in the study. In this prospective, randomised controlled study, two groups were constituted as with warmed (Group N) and not warmed (Group C) patients before and during the operation. Diuresis, blood loss, body temperature and side effects were recorded with IL-8, IL-10, IL-18, IL-23, PTX-3, cortisol and insulin levels.
Perioperative diuresis was significantly higher in Group C. Aldrete score was significantly higher in Group N with less shivering and vomiting in the postoperative period. IL-10, PTX-3 and cortisol levels were found to be significantly higher in Group C in the first postoperative hour. PTX-3 and cortisol were found to be significantly higher in Group C after 24 h of the operation. Insulin was significantly higher in Group N. In 72 h, IL-8 in Group N and cortisol level in Group C were significantly higher.
Positive effects of heating the patients in the perioperative period on haemorrhage, diuresis, complications and recovery time were observed in our study. In addition, maintenance of normothermia appeared to modulate the biomarkers that indicate the inflammatory and metabolic responses.
The US Dietary Guidelines (USDG) form the basis of nutrition guidelines, but the research informing the 3 USDG dietary patterns (Healthy US-Style H-US, Mediterranean Med, and vegetarian Veg) has been ...drawn largely from observational studies among White populations.
The Dietary Guidelines 3 Diets study was a 3-arm, 12-wk randomly assigned intervention among African American (AA) adults at risk of type 2 diabetes mellitus that tested the 3 USDG dietary patterns.
The AAs (ages 18–65 y, BMI 25–49.9 kg/m2, and BMI was measured in kg/m2) with ≥3 type 2 diabetes mellitus risk factors were recruited. Weight, HbA1c, blood pressure, and dietary quality (healthy eating index HEI) were collected at baseline and 12 wk. In addition, participants attended weekly online classes that were designed using material from the USDG/MyPlate. Repeated measures, mixed models with maximum likelihood estimation, and robust computation of standard errors were tested.
Of the 227 participants screened, 63 were eligible (83% female; age 48.0 ± 10.6 y, BMI 35.9 ± 0.8 kg/m2) and randomly assigned to the Healthy US-Style Eating Pattern (H-US) (n = 21, 81% completion), healthy Mediterranean-style eating pattern (Med) (n = 22, 86% completion), or healthy vegetarian eating pattern (Veg) (n = 20, 70% completion) groups. Within-group, but not between groups, weight loss was significant (−2.4 ± 0.7 kg H-US, −2.6 ± 0.7 kg Med, −2.4 ± 0.8 kg Veg; P = 0.97 between group). There was also no significant difference between groups for changes in HbA1c (0.03 ± 0.05% H-US, −0.10 ± 0.05% Med, 0.07 ± 0.06% Veg; P = 0.10), systolic BP (−5.5 ± 2.7 mmHg H-US, −3.2 ± 2.5 mmHg Med, −2.4 ± 2.9 mmHg Veg; P = 0.70), diastolic blood pressure (−5.2 ± 1.8 mmHg H-US, −2.0 ± 1.7 mmHg Med, −3.4 ± 1.9 mmHg Veg; P = 0.41), or HEI (7.1 ± 3.2 H-US, 15.2 ± 3.1 Med, 4.6 ± 3.4 Veg; P = 0.06). Post hoc analyses showed that the Med group had significantly greater improvements in HEI compared to the Veg group (difference = −10.6 ± 4.6; 95% CI: −19.7, −1.4; P = 0.02).
The present study demonstrates that all 3 USDG dietary patterns lead to significant weight loss among AA adults. However, none of the outcomes were significantly different between groups.
This trial was registered at clinicaltrials.gov as NCT04981847.
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