-
Pharmacology & Therapeutics May 2024Chronic Obstructive Pulmonary Disease (COPD) is a multifaceted respiratory disorder characterized by progressive airflow limitation and systemic implications. It has... (Review)
Review
Chronic Obstructive Pulmonary Disease (COPD) is a multifaceted respiratory disorder characterized by progressive airflow limitation and systemic implications. It has become increasingly apparent that COPD exerts its influence far beyond the respiratory system, extending its impact to various organ systems. Among these, the musculoskeletal system emerges as a central player in both the pathogenesis and management of COPD and its associated comorbidities. Muscle dysfunction and osteoporosis are prevalent musculoskeletal disorders in COPD patients, leading to a substantial decline in exercise capacity and overall health. These manifestations are influenced by systemic inflammation, oxidative stress, and hormonal imbalances, all hallmarks of COPD. Recent research has uncovered an intricate interplay between COPD and musculoskeletal comorbidities, suggesting that muscle and bone tissues may cross-communicate through the release of signalling molecules, known as "myokines" and "osteokines". We explored this dynamic relationship, with a particular focus on the role of the immune system in mediating the cross-communication between muscle and bone in COPD. Moreover, we delved into existing and emerging therapeutic strategies for managing musculoskeletal disorders in COPD. It underscores the development of personalized treatment approaches that target both the respiratory and musculoskeletal aspects of COPD, offering the promise of improved well-being and quality of life for individuals grappling with this complex condition. This comprehensive review underscores the significance of recognizing the profound impact of COPD on the musculoskeletal system and its comorbidities. By unravelling the intricate connections between these systems and exploring innovative treatment avenues, we can aspire to enhance the overall care and outcomes for COPD patients, ultimately offering hope for improved health and well-being.
Topics: Humans; Quality of Life; Pulmonary Disease, Chronic Obstructive; Comorbidity; Lung; Musculoskeletal Diseases
PubMed: 38508342
DOI: 10.1016/j.pharmthera.2024.108635 -
Journal of Magnetic Resonance Imaging :... Dec 2020Deep learning is one of the most exciting new areas in medical imaging. This review article provides a summary of the current clinical applications of deep learning for... (Review)
Review
Deep learning is one of the most exciting new areas in medical imaging. This review article provides a summary of the current clinical applications of deep learning for lesion detection, progression, and prediction of musculoskeletal disease on radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine. Deep-learning methods have shown success for estimating pediatric bone age, detecting fractures, and assessing the severity of osteoarthritis on radiographs. In particular, the high diagnostic performance of deep-learning approaches for estimating pediatric bone age and detecting fractures suggests that the new technology may soon become available for use in clinical practice. Recent studies have also documented the feasibility of using deep-learning methods for identifying a wide variety of pathologic abnormalities on CT and MRI including internal derangement, metastatic disease, infection, fractures, and joint degeneration. However, the detection of musculoskeletal disease on CT and especially MRI is challenging, as it often requires analyzing complex abnormalities on multiple slices of image datasets with different tissue contrasts. Thus, additional technical development is needed to create deep-learning methods for reliable and repeatable interpretation of musculoskeletal CT and MRI examinations. Furthermore, the diagnostic performance of all deep-learning methods for detecting and characterizing musculoskeletal disease must be evaluated in prospective studies using large image datasets acquired at different institutions with different imaging parameters and different imaging hardware before they can be implemented in clinical practice. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY STAGE: 2 J. MAGN. RESON. IMAGING 2020;52:1607-1619.
Topics: Child; Deep Learning; Humans; Magnetic Resonance Imaging; Musculoskeletal Diseases; Prospective Studies; Tomography, X-Ray Computed
PubMed: 31763739
DOI: 10.1002/jmri.27001 -
Expert Reviews in Molecular Medicine Mar 2022Coronavirus disease 2019 (COVID-19) is associated with autoimmunity and systemic inflammation. Patients with autoimmune rheumatic and musculoskeletal disease (RMD) may... (Review)
Review
Coronavirus disease 2019 (COVID-19) is associated with autoimmunity and systemic inflammation. Patients with autoimmune rheumatic and musculoskeletal disease (RMD) may be at high risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this review, based on evidence from the literature, as well as international scientific recommendations, we review the relationships between COVID-19, autoimmunity and patients with autoimmune RMDs, as well as the basics of a multisystemic inflammatory syndrome associated with COVID-19. We discuss the repurposing of pharmaceutics used to treat RMDs, the principles for the treatment of patients with autoimmune RMDs during the pandemic and the main aspects of vaccination against SARS-CoV-2 in autoimmune RMD patients.
Topics: Autoimmunity; COVID-19; Humans; Inflammation; Musculoskeletal Diseases; SARS-CoV-2; COVID-19 Drug Treatment
PubMed: 35311631
DOI: 10.1017/erm.2022.10 -
JMIR Public Health and Surveillance Nov 2023Sleep is an important physiological behavior in humans that is associated with the occurrence and development of various diseases. However, the association of sleep...
The Effect of Sleep on Metabolism, Musculoskeletal Disease, and Mortality in the General US Population: Analysis of Results From the National Health and Nutrition Examination Survey.
BACKGROUND
Sleep is an important physiological behavior in humans that is associated with the occurrence and development of various diseases. However, the association of sleep duration with health-related outcomes, including obesity-related factors, musculoskeletal diseases, and mortality because of different causes, has not been systematically reported.
OBJECTIVE
This study aims to systematically investigate the effect of sleep duration on health-related outcomes.
METHODS
Overall, 54,664 participants with sleep information from 8 survey cycles of the National Health and Nutrition Examination Survey (2005-2020) were included in the analysis. Health-related outcomes comprised obesity-related outcomes (ie, BMI, obesity, waist circumference, and abdominal obesity), metabolism-related outcomes (ie, uric acid, hyperuricemia, and bone mineral density [BMD]), musculoskeletal diseases (ie, osteoarthritis [OA] and rheumatoid arthritis [RA]), and mortality because of different causes. The baseline information of participants including age, sex, race, educational level, marital status, total energy intake, physical activity, alcohol consumption, smoking, hypertension, and diabetes was also collected as covariates. Information about the metabolism index, disease status, and covariates was acquired from the laboratory, examination, and questionnaire data. Survival information, including survival status, duration, and cause of death, was obtained from the National Death Index records. Quantile regression models and Cox regression models were used for association analysis between sleep duration and health-related outcomes. In addition, the threshold effect analysis, along with smooth curve fitting method, was applied for the nonlinear association analysis.
RESULTS
Participants were divided into 4 groups with different sleep durations. The 4 groups showed significant differences in terms of baseline data (P<.001). The quantile regression analysis indicated that participants with increased sleep duration showed decreased BMI (β=-.176, 95% CI -.220 to -.133; P<.001), obesity (odds ratio [OR] 0.964, 95% CI 0.950-0.977; P<.001), waist circumference (β=-.219, 95% CI -.320 to -.117; P<.001), abdominal obesity (OR 0.975, 95% CI 0.960-0.990; P<.001), OA (OR 0.965, 95% CI 0.942-0.990; P=.005), and RA (OR 0.940, 95% CI 0.912-0.968; P<.001). Participants with increased sleep duration also showed increased BMD (β=.002, 95% CI .001-.003; P=.005), as compared with participants who slept <5.5 hours. A significant saturation effect of sleep duration on obesity, abdominal obesity, and hyperuricemia was detected through smooth curve fitting and threshold effect analysis (sleep duration>inflection point). In addition, a significant threshold effect of sleep duration on BMD (P<.001); OA (P<.001); RA (P<.001); and all-cause (P<.001), cardiovascular disease-cause (P<.001), cancer-cause (P=.005), and diabetes-cause mortality (P<.001) was found. The inflection point was between 6.5 hours and 9 hours.
CONCLUSIONS
The double-edged sword effect of sleep duration on obesity-related outcomes, embolism-related diseases, musculoskeletal diseases, and mortality because of different causes was detected in this study. These findings provided epidemiological evidence that proper sleep duration may be an important factor in the prevention of multisystem diseases.
Topics: Humans; Nutrition Surveys; Obesity, Abdominal; Hyperuricemia; Sleep; Musculoskeletal Diseases; Osteoarthritis; Obesity; Diabetes Mellitus
PubMed: 37934562
DOI: 10.2196/46385 -
Aging Clinical and Experimental Research May 2018Musculoskeletal disorders affect morbidity, quality of life and mortality, and represent an increasing economic and societal burden in the context of population aging... (Review)
Review
Musculoskeletal disorders affect morbidity, quality of life and mortality, and represent an increasing economic and societal burden in the context of population aging and increased life expectancy. Improvement of quality of life should be one of the priorities of any interventions to prevent and treat musculoskeletal disorders in the ageing population. Two main approaches, namely generic and disease-specific instruments, can be applied to measure health-related quality of life. Among the generic tools available in scientific literature, the short form 36 questionnaire (SF-36) and the Euroqol five item questionnaire (EQ-5D) are two of the most popular questionnaires used to quantify the health related quality of life in people with musculoskeletal disorders. However, because generic tools may not always be able to detect subtle effects of a specific condition on quality of life, a specific tool is highly valuable. Specific tools improve the ability to clinically characterize quality of life in subjects with a specific musculoskeletal disorder, as well as the capacity to assess changes over time in the QoL of these subjects. The recent development of specific tools should help to validate preventive and therapeutic interventions in this field.
Topics: Adult; Cost of Illness; Female; Fractures, Bone; Frailty; Humans; Incidence; Musculoskeletal Diseases; Osteoarthritis; Osteoporosis; Quality of Life; Sarcopenia; Surveys and Questionnaires
PubMed: 28664458
DOI: 10.1007/s40520-017-0794-8 -
Biology of Blood and Marrow... May 2015Chronic graft-versus-host disease (cGVHD) has the potential to cause significant morbidity and mortality in people who undergo allogeneic hematopoietic stem cell... (Review)
Review
Chronic graft-versus-host disease (cGVHD) has the potential to cause significant morbidity and mortality in people who undergo allogeneic hematopoietic stem cell transplantation. Management of complications due to cGVHD can be challenging because of multiorgan involvement and variable presentation of the disease. This paper outlines the diagnosis and management of musculoskeletal, neurologic, and cardiopulmonary manifestations of cGVHD that have the potential to cause profound functional impairment and that may significantly impact quality of life and lifespan. Expert evaluation by a physical medicine and rehabilitation physician and multidisciplinary team may be beneficial in the treatment of the disease sequelae, and examples of specific rehabilitation interventions are described.
Topics: Allografts; Chronic Disease; Graft vs Host Disease; Heart Diseases; Hematopoietic Stem Cell Transplantation; Humans; Lung Diseases; Musculoskeletal Diseases; Nervous System Diseases
PubMed: 25445027
DOI: 10.1016/j.bbmt.2014.10.019 -
BMC Musculoskeletal Disorders Apr 2019We live in a world with an ever-increasing ageing population. Studying healthy ageing and reducing the socioeconomic impact of age-related diseases is a key research... (Review)
Review
We live in a world with an ever-increasing ageing population. Studying healthy ageing and reducing the socioeconomic impact of age-related diseases is a key research priority for the industrialised and developing countries, along with a better mechanistic understanding of the physiology and pathophysiology of ageing that occurs in a number of age-related musculoskeletal disorders. Arthritis and musculoskeletal disorders constitute a major cause of disability and morbidity globally and result in enormous costs for our health and social-care systems.By gaining a better understanding of healthy musculoskeletal ageing and the risk factors associated with premature ageing and senescence, we can provide better care and develop new and better-targeted therapies for common musculoskeletal disorders. This review is the outcome of a two-day multidisciplinary, international workshop sponsored by the Institute of Advanced Studies entitled "Musculoskeletal Health in the 21st Century" and held at the University of Surrey from 30th June-1st July 2015.The aim of this narrative review is to summarise current knowledge of musculoskeletal health, ageing and disease and highlight strategies for prevention and reducing the impact of common musculoskeletal diseases.
Topics: Aging; Consensus Development Conferences as Topic; Cost of Illness; Global Health; Health Status; Healthy Aging; Humans; Interdisciplinary Communication; International Cooperation; Musculoskeletal Diseases; Musculoskeletal Physiological Phenomena; Risk Factors
PubMed: 30971232
DOI: 10.1186/s12891-019-2510-7 -
Medical Principles and Practice :... 2020Recent studies indicate that India is an endemic region for Burkholderia pseudomallei infection. We aimed to describe the clinical presentation of B. pseudomallei...
OBJECTIVE
Recent studies indicate that India is an endemic region for Burkholderia pseudomallei infection. We aimed to describe the clinical presentation of B. pseudomallei infection of the musculoskeletal system and summarise the various treatment modalities used in our clinical practice.
SUBJECTS AND METHODS
Patients with confirmed microbiological diagnosis of B. pseudomallei infection involving the musculoskeletal system treated from January 2007 to December 2016 with a minimum follow-up of 1 year were included. A retrospective review of medical records was carried out and patients' demographic data, co-morbidities, clinical presentation, and details of medical and surgical treatment were documented.
RESULTS
Of 342 patients diagnosed with B. pseudomallei infection, 37 (9.2%) had musculoskeletal involvement; 26 patients (23 males) followed up for at least a year were included in the study. Four patients (15%) had multisystem involvement and 10 (37%) had multiple musculoskeletal foci of infection; 15 patients (58%) had osteomyelitis, 10 (38%) had septic arthritis with or without osteomyelitis, and 1 patient (4%) presented with only soft tissue abscess. All patients required surgical intervention in addition to medical management. Surgical treatment varied from soft tissue abscess drainage, arthrotomy for septic arthritis, decompression and curettage for osteomyelitis, and/or use of antibiotic (meropenem or ceftazidime)-loaded polymethylmethacrylate bone cement for local drug delivery. At final follow-up (average: 37 months, range: 12-120), all patients were disease free.
CONCLUSION
We found the rate of musculoskeletal involvement in B. pseudomallei infection to be 9.2%. Appropriate surgical treatment in addition to medical management resulted in resolution of disease in all our patients.
Topics: Adult; Aged; Burkholderia pseudomallei; Female; Humans; India; Male; Melioidosis; Middle Aged; Musculoskeletal Diseases; Musculoskeletal System; Retrospective Studies; Treatment Outcome; Young Adult
PubMed: 31473744
DOI: 10.1159/000503021 -
The British Journal of General Practice... Jun 2004Musculoskeletal disease accounts for a large proportion of a general practitioner's (GP's) workload. Proper management can not only improve quality of care, but also... (Review)
Review
Musculoskeletal disease accounts for a large proportion of a general practitioner's (GP's) workload. Proper management can not only improve quality of care, but also increase job satisfaction and reap rewards under the new contract. Osteoporosis creates a huge socioeconomic burden of disease and disability. Identifying high-risk groups in primary care and using preventative treatment can result in a substantial reduction in morbidity and mortality. GPs can help by presenting a unified lifestyle message, advising on fall prevention, and providing effective treatment; in particular, calcium and vitamin D for female nursing home residents. Osteoarthritis is eminently treatable in primary care with a number of management options for GPs, in addition to drug therapy. Glucosamine and chondroitin have few side effects and are worth recommending to patients with mild knee osteoarthritis. Rheumatoid arthritis can cause significant disability, which can be limited by early diagnosis, referral, and treatment. Severe refractory rheumatoid arthritis may warrant referral for consideration of biologic therapy. Assessment of the cardiovascular risk and possible use of statins in rheumatoid patients may reduce their cardiovascular mortality. GPs should aim to help patients to achieve optimum quality of life by using a holistic approach and by allowing maximum choice and control over their disease.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Arthritis, Rheumatoid; Exercise Therapy; Humans; Musculoskeletal Diseases; Osteoarthritis; Osteoporosis; Rheumatology
PubMed: 15186570
DOI: No ID Found -
Journal of Evaluation in Clinical... Feb 2015Complex and chronic disease is placing significant pressure on hospital outpatient departments. Novel ways of delivering care have been developed recently and are often... (Review)
Review
RATIONALE, AIMS AND OBJECTIVES
Complex and chronic disease is placing significant pressure on hospital outpatient departments. Novel ways of delivering care have been developed recently and are often described as 'triage' services. This paper reviews the literature pertaining to definitions and descriptions of orthopaedic/musculoskeletal triage processes, in order to provide information on 'best practice' to assist health care facilities.
METHOD
A comprehensive open-ended search was conducted using electronic databases to identify studies describing models of triage clinics for patients with a musculoskeletal/orthopaedic complaint, who have been referred to hospital outpatient clinics for a surgical consultation. Studies were critically appraised using the McMaster quality appraisal tool and ranked using the National Health and Medical Research Council hierarchy of evidence. A thematic analysis of the definitions, processes and procedures of triage described within the literature was undertaken.
RESULTS
1930 studies were identified and 45 were included in the review (including diagnostic and evaluative research). The hierarchy of evidence ranged from I to IV; however, the majority were at low levels of evidence and scored poorly on the critical appraisal tool. Three broad themes of triage were identified: presence of a referral, configuration of the triage (who, how and where) and the aim of triage. However, there were significant inconsistencies across these themes.
CONCLUSIONS
This systematic review highlighted the need for standardization of the definition of triage, the procedures of assessment and management and measures of outcome used in orthopaedic/musculoskeletal triage to ensure best-practice processes, procedures and outcomes for triage clinics.
Topics: Health Personnel; Humans; Musculoskeletal Diseases; Orthopedics; Outpatient Clinics, Hospital; Referral and Consultation; Triage
PubMed: 25410703
DOI: 10.1111/jep.12260