Risk factors for low back pain and sciatica: an umbrella review.

Molecular genetics of human obesity: A comprehensive review.

Suicide accounts for nearly 800,000 deaths per year worldwide with rates of both deaths and attempts rising. Family studies have estimated substantial heritability of suicidal behavior; however, collecting the sample sizes necessary for successful genetic studies has remained a challenge. We utilized two different approaches in independent datasets to characterize the contribution of common genetic variation to suicide attempt. The first is a patient reported suicide attempt phenotype asked as part of an online mental health survey taken by a subset of participants (n = 157,366) in the UK Biobank. After quality control, we leveraged a genotyped set of unrelated, white British ancestry participants including 2433 cases and 334,766 controls that included those that did not participate in the survey or were not explicitly asked about attempting suicide. The second leveraged electronic health record (EHR) data from the Vanderbilt University Medical Center (VUMC, 2.8 million patients, 3250 cases) and machine learning to derive probabilities of attempting suicide in 24,546 genotyped patients. We identified significant and comparable heritability estimates of suicide attempt from both the patient reported phenotype in the UK Biobank (h2SNP = 0.035, p = 7.12 × 10−4) and the clinically predicted phenotype from VUMC (h2SNP = 0.046, p = 1.51 × 10−2). A significant genetic overlap was demonstrated between the two measures of suicide attempt in these independent samples through polygenic risk score analysis (t = 4.02, p = 5.75 × 10−5) and genetic correlation (rg = 1.073, SE = 0.36, p = 0.003). Finally, we show significant but incomplete genetic correlation of suicide attempt with insomnia (rg = 0.34–0.81) as well as several psychiatric disorders (rg = 0.26–0.79). This work demonstrates the contribution of common genetic variation to suicide attempt. It points to a genetic underpinning to clinically predicted risk of attempting suicide that is similar to the genetic profile from a patient reported outcome. Lastly, it presents an approach for using EHR data and clinical prediction to generate quantitative measures from binary phenotypes that can improve power for genetic studies.

/pdf/significant-shared-heritability-underlies-suicide-attempt-5ah2em298a.pdf

Significant shared heritability underlies suicide attempt and clinically predicted probability of attempting suicide

Intervertebral disc degeneration (IVDD) is a chronic, expensive, and high-incidence musculoskeletal disorder largely responsible for back/neck and radicular-related pain. It is characterized by progressive degenerative damage of intervertebral tissues along with metabolic alterations of all other vertebral tissues. Despite the high socio-economic impact of IVDD, little is known about its etiology and pathogenesis, and currently, no cure or specific treatments are available. Recent evidence indicates that besides abnormal and excessive mechanical loading, inflammation may be a crucial player in IVDD. Furthermore, obese adipose tissue is characterized by a persistent and low-grade production of systemic pro-inflammatory factors. In this context, chronic low-grade inflammation associated with obesity has been hypothesized as an important contributor to IVDD through different, but still unknown, mechanisms. Adipokines, such as leptin, produced prevalently by white adipose tissues, but also by other cells of mesenchymal origin, particularly cartilage and bone, are cytokine-like hormones involved in important physiologic and pathophysiological processes. Although initially restricted to metabolic functions, adipokines are now viewed as key players of the innate and adaptative immune system and active modulators of the acute and chronic inflammatory response. The goal of this review is to summarize the most recent findings regarding the interrelationships among inflammation, obesity and the pathogenic mechanisms involved in the IVDD, with particular emphasis on the contribution of adipokines and their potential as future therapeutic targets.

https://www.mdpi.com/1422-0067/20/8/2030/pdf

Molecular Relationships among Obesity, Inflammation and Intervertebral Disc Degeneration: Are Adipokines the Common Link?

Intervertebral disc (IVD) degeneration is a common finding on spine imaging that increases in prevalence with age. IVD degeneration is a frequent cause of low back pain, which is a leading cause of disability. The process of IVD degeneration consists of gradual structural change accompanied by severe alterations in metabolic homeostasis. IVD degeneration, like osteoarthritis, is a common comorbidity in patients with obesity and type 2 diabetes mellitus, two metabolic syndrome pathological conditions in which adipokines are important promoters of low-grade inflammation, extracellular matrix degradation and fibrosis. Impairment in white adipose tissue function, due to the abnormal fat accumulation in obesity, is characterized by increased production of specific pro-inflammatory proteins such as adipokines by white adipose tissue and of cytokines such as TNF by immune cells of the stromal compartment. Investigations into the immunometabolic alterations in obesity and type 2 diabetes mellitus and their interconnections with IVD degeneration provide insights into how adipokines might affect the pathogenesis of IVD degeneration and impair IVD function and repair. Toll-like receptor-mediated signalling has also been implicated as a promoter of the inflammatory response in the metabolic alterations associated with IVD and is thus thought to have a role in IVD degeneration. Pathological starvation, obesity and adipokine dysregulation can result in immunometabolic alterations, which could be targeted for the development of new therapeutics.

A new immunometabolic perspective of intervertebral disc degeneration.

The relationship between obesity, low back pain, and lumbar disc degeneration when genetics and the environment are considered: a systematic review of twin studies.

The purpose of the study was to analyze the electromyographic signal of the multifidus, longissimus thoracis and the lumbar iliocostalis muscles during the Biering-Sorensen test in subjects without lower back pain. Twenty volun- teers performed the test on three separate occasions. An analysis of variance detected a difference between the three test times (p = 0.0026). For the frequency domain, it was observed that there were differences between the multifidus and the lumbar erectors muscles; longissimus and iliocostalis muscles. However, in the time domain analysis, no difference was observed. As the values of the slope coefficients of median frequencies were higher for the multifidus muscle, com - pared to the longissimus and lumbar iliocostalis muscles, this may indicate a higher tendency toward muscle fatigue. Therefore, considering the applied methodology, the study of electromyographic signals in the frequency domain should be considered as an instrument to assess fatigue of the spinal extensor muscles in clinical situations.

/pdf/electromyographic-analysis-of-the-vertebral-extensor-muscles-2bjo636hef.pdf

Electromyographic analysis of the vertebral extensor muscles during the Biering-Sorensen Test

O objetivo do presente estudo foi investigar e identificar os artigos publicados em periodicos nacionais que aplicaram testes de normalidade, quais os mais utilizados, se ha relacao com o Qualis e se no decorrer dos anos ha um aumento na utilizacao desses testes. Para elaboracao da pesquisa foram escolhidos tres periodicos nacionais indexados no SciELO. Foram analisadas publicacoes entre 2008 e 2012. A analise descritiva foi realizada no Excel 2007 e o teste de normalidade (Shapiro Wilk) pelo SPSS, assim como a comparacao entre grupos (ANOVA one way), com nivel de significância de 5%. Dentre a totalidade dos Artigos Originais (n=871), foi observado que 358 citaram a utilizacao de teste de normalidade. Em suma, pode-se afirmar que a Revista Brasileira de Fisioterapia e responsavel por 46% dessas publicacoes. A Revista Fisioterapia e Pesquisa e Revista Fisioterapia em Movimento sao responsaveis por 30,2% e 23,7% das publicacoes, respectivamente. Os testes estatisticos mais utilizados foram Shapiro-Wilk (n=163) e Komolgorov-Smirnov (n=137). Estes foram responsaveis por 83,8% das publicacoes que citaram testar a normalidade de seus dados. Ainda, 2,8% executaram outros testes e 13,4% nao especificaram qual teste utilizado, porem, afirmaram testar a normalidade. Conclui-se entao que o periodico nacional de maior Qualis, a Revista Brasileira de Fisioterapia, possui maior rigor criterioso em relacao a analise estatistica e que nao ha diferenca estatisticamente significante no numero de artigos publicados que aplicaram o teste de normalidade no decorrer dos anos. Observa-se tambem que o teste de Shapiro-Wilk foi o mais utilizado nas publicacoes.

/pdf/aplicacao-de-testes-de-normalidade-em-publicacoes-nacionais-2b6q3mt90s.pdf

Thais de Sousa Lima

Papers

The relationship between obesity, low back pain, and lumbar disc degeneration when genetics and the environment are considered: a systematic review of twin studies.

Electromyographic analysis of the vertebral extensor muscles during the Biering-Sorensen Test

Aplicação de testes de normalidade em publicações nacionais: levantamento bibliográfico