Search

Background Musculoskeletal (MSK) disorders are one of the main causes of disability among adults globally. The burden of MSK disorders varies greatly between different regions and is the highest in low- and middle income- countries. This study sought to investigate trends in the burden of MSK disorders across the MENA region, utilizing the GBD 2019 dataset. Methods This study utilized data from the Global Burden of Disease (GBD). Using age standardized rates of prevalence and disability-adjusted life-years (DALYs), we report trends in the burden of MSK disorders in The Middle East and North Africa (MENA) region between 1990 and 2019. Furthermore, we analyze trends in risk factors contributing to MSK disorders. Results In 2019, the age-standardized rate prevalence and DALYs for all MSK disorders among both genders was 17706 [95% UI = 16641, 18794] and 1782 [95% UI = 1278, 2366], respectively. Low back pain continued to be the most prevalent MSK condition in 2019. Afghanistan had the lowest age standardized DALYs rate attributed to MSK disorders (1408 per 100,000; 95% UI = 980–1899), while Iran had the highest burden of 2007 per 100,000 (95% UI = 1440–2655). In 2019, occupational risks, high body mass index, and tobacco smoking were the main risk factors for DALYs of MSK disorders. Conclusion MSK disorders carry a large burden of disease in the MENA region, and multiple risk factors contribute to this increased burden in the past decades. Interventions that address risk factors have the potential to improve health outcomes among the population. Future research should continue to explore the burden of MSK disorders and better understand how to intervene.

PURPOSE OF REVIEW: Post-concussion syndrome (PCS), when the patient’s concussion symptoms last longer than 4–6 weeks, affects 10–30% of concussion patients. PCS presents a significant source of morbidity to patients and a management challenge to providers. In this review, we present the current evidence and best management approaches for pediatric PCS. RECENT FINDINGS: There is limited high-quality evidence in pediatric PCS. There is some evidence supporting pharmaceutical management of post-traumatic headaches, cognitive symptoms, and emotional symptoms. Vestibular-ocular dysfunction should be evaluated and managed appropriately. Neuropsychological recovery is expected, but requires appropriate attention to Return to Learn. Emotional symptoms are common in PCS and the evidence supports treatment with cognitive behavioral therapy. SUMMARY: PCS presents a unique therapeutic challenge affecting multiple domains for patients—physical, sleep, cognitive, and emotional. Successful management of PCS requires a multi-disciplinary and individualized approach. There remains a significant need for further research, specifically looking into the outcomes and effective interventions in pediatric PCS.

To describe factors associated with pressure ulcers in individuals with spina bifida (SB) enrolled in the National Spina Bifida Patient Registry (NSBPR).Unbalanced longitudinal multicenter cohort study.Nineteen SB clinics.Individuals with SB (N=3153) enrolled in 19 clinic sites that participate in the NSBPR.Not applicable.Pressure ulcer status (yes/no) at the annual visit between 2009 and 2012.Of 3153 total participants, 19% (n=603) reported ulcers at their most recent annual clinic visit. Seven factors-level of lesion, wheelchair use, urinary incontinence, shunt presence, above the knee orthopedic surgery, recent surgery, and male sex-were significantly associated with the presence of pressure ulcers. Of these factors, level of lesion, urinary incontinence, recent surgery, and male sex were included in the final logistic regression model. The 3 adjusting variables-SB type, SB clinic, and age group-were significant in all analyses (all P.001).By adjusting for SB type, SB clinic, and age group, we found that 7 factors-level of lesion, wheelchair use, urinary incontinence, shunt presence, above the knee orthopedic surgery, recent surgery, and male sex-were associated with pressure ulcers. Identifying key factors associated with the onset of pressure ulcers can be incorporated into clinical practice in ways that prevent and enhance treatment of pressure ulcers in the population with SB.