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Hubner FCL, Telles RW, Giatti L, Machado LAC, Griep RH, Viana MC, Barreto SM, Camelo LV. Job stress and chronic low back pain: incidence, number of episodes, and severity in a 4-year follow-up of the ELSA-Brasil Musculoskeletal cohort. Pain 2024:00006396-990000000-00610. [PMID: 38787636 DOI: 10.1097/j.pain.0000000000003276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 04/02/2024] [Indexed: 05/26/2024]
Abstract
ABSTRACT We investigated the association between job stress, as assessed by the effort-reward imbalance model, and the incidence of chronic low back pain (CLBP) over a 4-year period. A total of 1733 participants from the ELSA-Brasil Musculoskeletal cohort, who were free from LBP at baseline (2012-2014), were included. Episodes of LBP in the past 30 days, intensity, and the presence of disability were investigated in annual telephone follow-ups (2015-2018). Chronic LBP was defined as episodes of LBP lasting >3 months with at least moderate intensity. We analyzed the incidence of at least one episode of CLBP (yes/no), the number of CLBP episodes (0, 1, ≥2), and CLBP severity/disability (absent, nondisabling, severe/disabling). The association between these outcomes and tertiles of the effort-to-reward ratio, as well as each dimension of the effort-reward imbalance model, was investigated using multinomial logistic and Poisson regression models adjusting for sociodemographic and occupational variables. The cumulative incidence of CLBP over 4 years was 24.8%. High effort-reward imbalance increased the chances of experiencing multiple CLBP episodes and severe/disabling CLBP by 67% (95% confidence interval [CI]: 1.12-2.47) and 70% (95% CI: 1.14-2.53), respectively. High overcommitment increased the incidence of CLBP by 23% (95% CI: 1.01-1.50) and the chances of multiple CLBP episodes and severe/disabling CLBP by 67% (95% CI: 1.11-2.50) and 57% (95% CI: 1.05-2.34), respectively. These results indicate that exposure to job stress is associated with a higher incidence, a greater number of episodes, and increased severity of CLBP over a 4-year period. If this association is causal, measures aimed at reducing exposure to job stress are likely to alleviate the burden of CLBP.
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Affiliation(s)
- Fernanda Corsino Lima Hubner
- Postgraduate Program in Public Health, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rosa Weiss Telles
- Faculdade de Medicina and Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Luana Giatti
- Postgraduate Program in Public Health, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Faculdade de Medicina and Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Luciana A C Machado
- Faculdade de Medicina and Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Science Integrity Alliance, Sunrise, FL, United States
| | - Rosane Harter Griep
- Laboratory of Health and Environment Education, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Carmen Viana
- Department of Social Medicine, Postgraduate Program in Collective Health, Universidade Federal do Espirito Santo, Vitória, Brazil
| | - Sandhi Maria Barreto
- Postgraduate Program in Public Health, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Faculdade de Medicina and Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lidyane V Camelo
- Postgraduate Program in Public Health, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Faculdade de Medicina and Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Costa ABP, Machado LAC, Telles RW, Barreto SM. Obesity and the risk of multiple or severe frequent knee pain episodes: a 4-year follow-up of the ELSA-Brasil MSK cohort. Int J Obes (Lond) 2024; 48:65-70. [PMID: 37726404 DOI: 10.1038/s41366-023-01383-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/24/2023] [Accepted: 09/05/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND/OBJECTIVE Knee pain is an important health problem due to its high prevalence, negative impact on daily activities and quality of life, and societal burden. While the link between excess weight and knee pain has been well-documented in the literature, many studies are limited to patients with osteoarthritis or use cross-sectional data. This longitudinal study investigated whether overweight and obesity were associated with the frequency and severity of frequent knee pain (FKP) episodes over 4 years in civil servants enrolled in the ELSA-Brasil MSK cohort. METHODS Knee pain was assessed during baseline face-to-face interviews (2012-2014) and four yearly telephone follow-ups (2015-2019). Disabling FKP episodes or those of moderate to very severe intensity were classified as severe. Multinomial logistic regression models adjusted for confounders were used to test for associations in two participant groups: those with knee pain at baseline (prognosis cohort) and those without knee pain (incidence cohort). RESULTS A total of 2644 participants were included: 54.2% female, mean age 55.8 (SD 8.8) years. In the incidence cohort (n = 1896), obesity increased the risk of one (OR: 1.63; 95% CI 1.13-2.37) and multiple FKP episodes (OR: 2.61; 95% CI 1.71-3.97), as well as the risk of non-severe (OR: 1.72; 95% CI 1.04-2.84) and severe FKP episodes (OR: 2.10; 95% CI 1.50-2.95). In the prognosis cohort (n = 748), obesity increased the risk of multiple (OR: 2.54; 95% CI 1.60-4.05) and severe FKP episodes (OR: 2.31; 95% CI 1.49-3.59). Overweight presented the same trends but fell short of significance. CONCLUSIONS These results provide further support that overweight and obesity are important contributors to the incidence and worsening of FKP, and that weight management must be prioritized in multidisciplinary knee pain prevention and treatment programs to reduce the burden of musculoskeletal disorders.
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Affiliation(s)
- Aline Bárbara Pereira Costa
- Post-graduate Program in Public Health, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Luciana A C Machado
- Hospital das Clínicas/EBSERH, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Rosa Weiss Telles
- Department of Internal Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Rheumatology Service, Hospital das Clínicas/EBSERH, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Sandhi Maria Barreto
- Hospital das Clínicas/EBSERH, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
- Department of Preventive Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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Domingues JG, Araujo DC, Costa-Silva L, Machado AMC, Machado LAC, Veloso AA, Barreto SM, Telles RW. Development of a convolutional neural network for diagnosing osteoarthritis, trained with knee radiographs from the ELSA-Brasil Musculoskeletal. Radiol Bras 2023; 56:248-254. [PMID: 38204901 PMCID: PMC10775807 DOI: 10.1590/0100-3984.2023.0020-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/05/2023] [Accepted: 07/19/2023] [Indexed: 01/12/2024] Open
Abstract
Objective To develop a convolutional neural network (CNN) model, trained with the Brazilian "Estudo Longitudinal de Saúde do Adulto Musculoesquelético" (ELSA-Brasil MSK, Longitudinal Study of Adult Health, Musculoskeletal) baseline radiographic examinations, for the automated classification of knee osteoarthritis. Materials and Methods This was a cross-sectional study carried out with 5,660 baseline posteroanterior knee radiographs from the ELSA-Brasil MSK database (5,660 baseline posteroanterior knee radiographs). The examinations were interpreted by a radiologist with specific training, and the calibration was as established previously. Results The CNN presented an area under the receiver operating characteristic curve of 0.866 (95% CI: 0.842-0.882). The model can be optimized to achieve, not simultaneously, maximum values of 0.907 for accuracy, 0.938 for sensitivity, and 0.994 for specificity. Conclusion The proposed CNN can be used as a screening tool, reducing the total number of examinations evaluated by the radiologists of the study, and as a double-reading tool, contributing to the reduction of possible interpretation errors.
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Affiliation(s)
- Júlio Guerra Domingues
- Faculdade de Medicina da Universidade Federal de Minas Gerais
(UFMG), Belo Horizonte, MG, Brazil
| | - Daniella Castro Araujo
- Instituto de Ciências Exatas da Universidade Federal de
Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- Huna-AI, São Paulo, SP, Brazil
| | | | | | - Luciana Andrade Carneiro Machado
- Hospital das Clínicas da Universidade Federal de Minas
Gerais (UFMG)/Empresa Brasileira de Serviços Hospitalares (EBSERH), Belo
Horizonte, MG, Brazil
| | - Adriano Alonso Veloso
- Instituto de Ciências Exatas da Universidade Federal de
Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Sandhi Maria Barreto
- Faculdade de Medicina da Universidade Federal de Minas Gerais
(UFMG), Belo Horizonte, MG, Brazil
- Hospital das Clínicas da Universidade Federal de Minas
Gerais (UFMG)/Empresa Brasileira de Serviços Hospitalares (EBSERH), Belo
Horizonte, MG, Brazil
| | - Rosa Weiss Telles
- Faculdade de Medicina da Universidade Federal de Minas Gerais
(UFMG), Belo Horizonte, MG, Brazil
- Hospital das Clínicas da Universidade Federal de Minas
Gerais (UFMG)/Empresa Brasileira de Serviços Hospitalares (EBSERH), Belo
Horizonte, MG, Brazil
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