One-year outcomes of surgical versus nonsurgical treatments for discogenic back pain: a community-based prospective cohort study

ObjectivesCommunity-based screening for hepatitis B virus (HBV) and hepatitis C virus (HCV) is essential for hepatitis elimination. This study attempted to increase screening accessibility and efficacy by using alternative tools.DesignPopulation-based prospective cohort study.SettingHepatitis elimination program at Yunlin County, Taiwan.ParticipantsAll 4552 individuals participated in 60 screening sessions of a community-based HBV and HCV screening project in five rural townships with approximately 95 000 inhabitants in central-western Taiwan.InterventionsTo increase accessibility, 60 outreach screening sessions were conducted in 41 disseminative sites. Quantitative HBV surface antigen (qHBsAg) and anti-HCV testing with reflex HCV core antigen (HCV Ag) tests were employed as alternative screening tools.Main outcome measuresCalculate village-specific prevalence of HBsAg, anti-HCV and HCV Ag and establish patient allocation strategies according to levels of qHBsAg HCV Ag and alanine aminotransferase (ALT).ResultsOf 4552 participants, 553, 697 and 290 were positive for HBsAg, anti-HCV and HCV Ag, respectively; 75 of them had both HBsAg and anti-HCV positivity. The average (range) number of participants in each screening session was 98 (31–150). The prevalence rates (range) of HBsAg, anti-HCV and HCV Ag were 12.1% (4.3%–19.4%), 15.3% (2.6%–52.3%) and 6.4% (0%–30.2%), respectively. The HCV Ag positivity rate among anti-HCV-positive participants was 42% (0%–100%). Using cut-off values of >200 IU/mL for qHBsAg, >3 fmol/L for HCV Ag and >40 IU/mL for ALT as criteria for patient referral, we noted an 80.2% reduction in referral burden. Three villages had high anti-HCV prevalences of 52.3%, 53.8% and 63.4% with corresponding viraemic prevalences of 23.2%, 30.1% and 22% and thus constituted newly identified HCV-hyperendemic villages.ConclusionOutreach hepatitis screening increases accessibility for residents in rural communities. Screening HBV and HCV through qHBsAg and HCV Ag tests provides information concerning viral activities, which might be conducive to precise patient allocation in remote communities.

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Spinal mechanical load: a predictor of persistent low back pain? A prospective cohort study

European Spine Journal ◽

10.1007/s00586-007-0347-5 ◽

2007 ◽

Vol 16 (7) ◽

pp. 933-941 ◽

Cited By ~ 17

Author(s):

Eric W. P. Bakker ◽

Arianne P. Verhagen ◽

Cees Lucas ◽

Hans J. C. M. F. Koning ◽

Bart W. Koes

Keyword(s):

Cohort Study ◽

Low Back Pain ◽

Back Pain ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Mechanical Load ◽

Low Back

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Sleep problems increase the risk of musculoskeletal pain in boys but not girls: a prospective cohort study

European Journal of Pediatrics ◽

10.1007/s00431-020-03667-8 ◽

2020 ◽

Vol 179 (11) ◽

pp. 1711-1719

Author(s):

Alessandro Andreucci ◽

Paul Campbell ◽

Lisa K Mundy ◽

Susan M Sawyer ◽

Silja Kosola ◽

...

Keyword(s):

Cohort Study ◽

Musculoskeletal Pain ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Sleep Problems ◽

Large Population ◽

Population Based ◽

School Aged Children ◽

Increased Risk ◽

One Year

Abstract Adults with sleep problems are at higher risk for onset of musculoskeletal pain, but the evidence is less clear for children. This prospective cohort study investigated whether children with sleep problems are at higher risk for onset of musculoskeletal pain and explored whether sex is a modifier of this association. In a prospective cohort study of Australian schoolchildren (n = 1239, mean age 9 years), the associations between sleep problems at baseline and new onset of both musculoskeletal pain and persistent musculoskeletal pain (pain lasting > 3 months) 1 year later were investigated using logistic regression. The potential modifying effect of sex was also assessed. One-year incidence proportion for musculoskeletal pain onset is 43% and 7% for persistent musculoskeletal pain. Sleep problems were associated with musculoskeletal pain onset and persistent musculoskeletal pain onset in boys, odds ratio 2.80 (95% CI 1.39, 5.62) and OR 3.70 (1.30, 10.54), respectively, but not girls OR 0.58 (0.28, 1.19) and OR 1.43 (0.41, 4.95), respectively. Conclusions: Rates of musculoskeletal pain are high in children. Boys with sleep problems are at greater risk of onset of musculoskeletal pain, but girls do not appear to have higher risk. Consideration of sleep health may help prevent persistent musculoskeletal pain in children. What is Known:• Sleep problems are associated with the onset of musculoskeletal pain in adults.• It is not clear if the association between sleep problems and the onset of musculoskeletal pain is present also in children and if sex plays a role in this association. What is New:• This is the first large population-based study that has prospectively investigated the relationship between sleep problems and onset of musculoskeletal pain in school-aged children.• Children, especially boys with sleep problems, were at increased risk for the development of persistent musculoskeletal pain.

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