A Major earthquake and giant tsunami occurred on 3.11, which broadly affected the eastern Japan area along the Pacific Ocean. A large elderly population was confined to their place of refuge and faced a high risk of disuse syndrome due to immobility. Elderly survivors aged 65 and over who were markedly found in an inactive state due to immobilization were regarded as the “risk group” for inactive lifestyles, possibly leading to disuse syndromes. Intervention by means of rehabilitation assistance was required in approximately one third of these inactive survivors (“high risk group”), a rate which was significantly higher in the elderly over 65 years than in younger survivors. Establishment of a rehabilitation assistance system for use in the event of a mass disaster is one of the critical lessons learned following 3.11, which will contribute to serve as a prophylaxis against disuse syndromes arising from inactivate locomotive function. Legal reform of relief actions in mass disasters is highly required to also include physical therapists as official members.

A Major earthquake and giant tsunami occurred on 3.11, which broadly affected the eastern Japan area along the Pacific Ocean. A large elderly population was confined to their place of refuge and faced a high risk of disuse syndrome due to immobility. Elderly survivors aged 65 and over who were markedly found in an inactive state due to immobilization were regarded as the “risk group” for inactive lifestyles, possibly leading to disuse syndromes. Intervention by means of rehabilitation assistance was required in approximately one third of these inactive survivors (“high risk group”), a rate which was significantly higher in the elderly over 65 years than in younger survivors. Establishment of a rehabilitation assistance system for use in the event of a mass disaster is one of the critical lessons learned following 3.11, which will contribute to serve as a prophylaxis against disuse syndromes arising from inactivate locomotive function. Legal reform of relief actions in mass disasters is highly required to also include physical therapists as official members.

Background: This study examined the bidirectional and temporal-ordinal relationship between loneliness and back pain. Methods: Data from 7,730 participants in waves 6 (2012–2013), 7 (2014–2015), and 8 (2016–2017) of the national English Longitudinal Study of Ageing were analyzed. Back pain was graded on a scale of 0–10 (0, no discomfort; 10, unbearable pain). Loneliness was measured using the Revised University of California Los Angeles Loneliness Scale. A targeted minimum loss-based estimator was used to examine the bidirectional longitudinal associations between back pain and loneliness. Results: No loneliness in waves 6 and 7 (relative risk [RR]=0.76; 95% confidence interval [CI], 0.61–0.94), no loneliness in wave 6 but loneliness in wave 7 (RR=0.58; 95% CI, 0.50–0.68), and loneliness in wave 6 but not in wave 7 (RR=0.69; 95% CI, 0.57–0.86) were associated with significant risk reductions of back pain in wave 8 compared with the scenario of loneliness in waves 6 and 7. Mild back pain in wave 6 but moderate back pain (RR=0.55; 95% CI, 0.35–0.86) or severe back pain in wave 7 (RR=0.49; 95% CI, 0.34–0.72) showed a significant risk reduction of loneliness in wave 8 compared with severe back pain in waves 6 and 7. Conclusion Loneliness may be a risk factor for back pain, and back pain may be a risk factor for loneliness. The results of this study will inform the development of more effective interventions for loneliness and back pain.

Background: This study examined the bidirectional and temporal-ordinal relationship between loneliness and back pain. Methods: Data from 7,730 participants in waves 6 (2012–2013), 7 (2014–2015), and 8 (2016–2017) of the national English Longitudinal Study of Ageing were analyzed. Back pain was graded on a scale of 0–10 (0, no discomfort; 10, unbearable pain). Loneliness was measured using the Revised University of California Los Angeles Loneliness Scale. A targeted minimum loss-based estimator was used to examine the bidirectional longitudinal associations between back pain and loneliness. Results: No loneliness in waves 6 and 7 (relative risk [RR]=0.76; 95% confidence interval [CI], 0.61–0.94), no loneliness in wave 6 but loneliness in wave 7 (RR=0.58; 95% CI, 0.50–0.68), and loneliness in wave 6 but not in wave 7 (RR=0.69; 95% CI, 0.57–0.86) were associated with significant risk reductions of back pain in wave 8 compared with the scenario of loneliness in waves 6 and 7. Mild back pain in wave 6 but moderate back pain (RR=0.55; 95% CI, 0.35–0.86) or severe back pain in wave 7 (RR=0.49; 95% CI, 0.34–0.72) showed a significant risk reduction of loneliness in wave 8 compared with severe back pain in waves 6 and 7. Conclusion Loneliness may be a risk factor for back pain, and back pain may be a risk factor for loneliness. The results of this study will inform the development of more effective interventions for loneliness and back pain.

Background: This study examined the bidirectional and temporal-ordinal relationship between loneliness and back pain. Methods: Data from 7,730 participants in waves 6 (2012–2013), 7 (2014–2015), and 8 (2016–2017) of the national English Longitudinal Study of Ageing were analyzed. Back pain was graded on a scale of 0–10 (0, no discomfort; 10, unbearable pain). Loneliness was measured using the Revised University of California Los Angeles Loneliness Scale. A targeted minimum loss-based estimator was used to examine the bidirectional longitudinal associations between back pain and loneliness. Results: No loneliness in waves 6 and 7 (relative risk [RR]=0.76; 95% confidence interval [CI], 0.61–0.94), no loneliness in wave 6 but loneliness in wave 7 (RR=0.58; 95% CI, 0.50–0.68), and loneliness in wave 6 but not in wave 7 (RR=0.69; 95% CI, 0.57–0.86) were associated with significant risk reductions of back pain in wave 8 compared with the scenario of loneliness in waves 6 and 7. Mild back pain in wave 6 but moderate back pain (RR=0.55; 95% CI, 0.35–0.86) or severe back pain in wave 7 (RR=0.49; 95% CI, 0.34–0.72) showed a significant risk reduction of loneliness in wave 8 compared with severe back pain in waves 6 and 7. Conclusion Loneliness may be a risk factor for back pain, and back pain may be a risk factor for loneliness. The results of this study will inform the development of more effective interventions for loneliness and back pain.

Background: This study examined the bidirectional and temporal-ordinal relationship between loneliness and back pain. Methods: Data from 7,730 participants in waves 6 (2012–2013), 7 (2014–2015), and 8 (2016–2017) of the national English Longitudinal Study of Ageing were analyzed. Back pain was graded on a scale of 0–10 (0, no discomfort; 10, unbearable pain). Loneliness was measured using the Revised University of California Los Angeles Loneliness Scale. A targeted minimum loss-based estimator was used to examine the bidirectional longitudinal associations between back pain and loneliness. Results: No loneliness in waves 6 and 7 (relative risk [RR]=0.76; 95% confidence interval [CI], 0.61–0.94), no loneliness in wave 6 but loneliness in wave 7 (RR=0.58; 95% CI, 0.50–0.68), and loneliness in wave 6 but not in wave 7 (RR=0.69; 95% CI, 0.57–0.86) were associated with significant risk reductions of back pain in wave 8 compared with the scenario of loneliness in waves 6 and 7. Mild back pain in wave 6 but moderate back pain (RR=0.55; 95% CI, 0.35–0.86) or severe back pain in wave 7 (RR=0.49; 95% CI, 0.34–0.72) showed a significant risk reduction of loneliness in wave 8 compared with severe back pain in waves 6 and 7. Conclusion Loneliness may be a risk factor for back pain, and back pain may be a risk factor for loneliness. The results of this study will inform the development of more effective interventions for loneliness and back pain.

BACKGROUND: Minocycline-induced pigmentation of bone (black bone) is well described in tooth-bearing intra-oral bone, but is less known in periarticular bone in patients who have undergone total joint arthroplasty. On a retrospective basis, we investigated the short-term clinico-radiological results of total joint arthroplasties in which the patient developed minocycline-induced periarticular black bone. METHODS: We found 5 cases (0.08%), in 4 patients, of periarticular bone pigmentation revealed during total joint arthroplasties (2 hips, 2 knees, and 1 ankle) in our series of total joint surgeries (6,548 cases) over a 10-year time period in our 3 institutes. Their mean age was 56 years at surgery. All patients had received long-term minocycline treatment. Mean dosage and duration of minocycline was 160 mg/day and 2.2 years, respectively. Minocycline had been prescribed for reactive arthritis (one), rheumatoid arthritis (two) and late infection after total joint arthroplasty (two patients). Mean follow-up period was 3.4 years after the surgeries. RESULTS: All cases had black or brown pigmentation in the periarticular bones during the surgery. There was no pigmentation in the cartilage or soft tissues of the joints. The mean Japanese Orthopaedic Association (JOA) score or Japanese Society for Surgery of the Foot (JSSF) scale for rheumatoid arthritis foot and ankle joints at latest follow-up (case 1, 66; case 2, 87; case 3, 77; case 4, 77; case 5, 80) improved compared to those of pre-surgery (case 1, 47; case 2, 45; case 3, 55; case 4, 34; case 5, 55). No implant loosening was noted on radiographic examination during the follow-up period. No abnormal bone formation, bone necrosis, hemosiderin deposition, malignancy or metallic debris was found on histological examination. CONCLUSIONS: No clinico-radiological symptoms of total joint arthroplasties showed in the patients with minocycline-induced periariticular black bone in the short-term. Systemic minocycline treatment has the potential to induce significant black pigmentation of many tissues. In particular, minocycline-induced pigmentation of periarticular bone may be accelerated by inflammation due to rheumatic or pyogenic arthritis. Surgeons should recognize the risk of bone pigmentation in inflamed joints due to the systemic treatment of minocycline and explore its influence on periarticular bone and total joint arthroplasty in the long-term.
Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/*adverse effects/therapeutic use ; Antibiotic Prophylaxis/adverse effects ; Arthritis/drug therapy/*pathology/prevention & control ; Arthroplasty, Replacement/*methods ; Bone and Bones/*drug effects/pathology ; Female ; Humans ; Male ; Middle Aged ; Minocycline/*adverse effects/therapeutic use ; Retrospective Studies ; Skin/pathology ; Skin Pigmentation