BackgroundBy aging, many changes occur in the different components of the locomotor system, leading to a pathological situation such as osteoarthritis or remaining totally asymptomatic.ObjectivesThe aim of the current study was to compare,via ultrasound, the entheseal changes in two groups of people having different ages by calculating a modified Madrid sonography enthesitis index.MethodsThe study was conducted in the rheumatology department of Mongi Slim hospital in Tunisia, between June 2015 and December 2016, including 17 healthy subjects. We indentified two groups: (G1) 9 persons aged >50 years [51–68] and (G2) 8 persons aged ≤50 years-old [37–50].All the included persons underwent an enthesis ultrasound exploration (EsaoteMyLab 60 machine and a 13–18 MHz linear array transducer) by a rheumatogist experimented in ultrasound. Five enthesis locations bilaterally (distal Achilles tendon, distal andproximal patellar ligaments, distal quadriceps, and brachial triceps tendons) in each person were explored.The following elemental lesions of enthesis were evaluated: thickness, presence of calcifications, erosions,enthesophyte, loss of fibrillar patternand power Doppler signal.The calculated index was compared by Mann-Whitney U test between cases and controls. The significance level was set at 5%.ResultsIn our study population, the median age was 51.8±2.3 years and the median body mass index was 30±1 kg/m2. This last was similar between the two groups. All included subjects were female.The total enthesitis index was higher in G1 (6.67±0.91)than G2 (3.50±0.73) with a statistically significant difference (p=0.01).Considering each evaluated enthesis, the distal patellar ligament score was significantly higher in the G1 (1.67±0.55 vs 0.25±0.16 with p=0.03). For the other enthesis, there was no significantly difference between the 2 groups.ConclusionsThe distal patellar ligament enthesis changes shown in older persons may be the traduction of a silent-stage of knee osteoarthritis.Disclosure of InterestNone declared
Background Hypertension is becoming increasingly frequent mainly in low and middle income countries. We aimed to assess the prevalence, awareness and control of hypertension among Tunisian adults and identify associated factors with hypertension control. Methods Data were obtained from the 2016 Tunisian Health Examination Survey, a household survey stratified at three degrees. Adults (age≥18 years old) were interviewed using an individual questionnaire, then three blood pressure measurement were performed. Participants were considered hypertensive if they were previously diagnosed or had a systolic blood pressure (SBP) ≥140mmhg and/or a diastolic blood pressure (DBP) ≥ 90mmhg during the survey. Were considered under control, treated persons with SBP<140 mmhg and a DBP<90 mmhg. A weighted binary logistic regression was used to assess associated factors with hypertension control. Input model variables were: sociodemographic variables, comorbidities and lifestyle factors. Results In this study, 8908 adults were enrolled with a mean age of 42.8±0.2 years old and a sex ratio (M/F) equal to 0.96. Among respondents, 29.3% (95% CI: 28.2-30.5) had hypertension, 60.7% (95% CI: 58.7-62.6) of them were unaware of their disease and only (29.5%, 95% CI: 28.2-30.5) of treated patients had a controlled hypertension. In multivariate analysis, eating more than five fruits and vegetables per day was independently associated with a better hypertension control (AOR=1.7, 95% CI: 1.1-2.5). In addition, participants living in northern Tunisia were more likely to have a controlled hypertension than those living in the south (AOR=1.9, 95% CI: 1.2-2.9). Conclusions Almost third of Tunisian adults were hypertensive. Low level of awareness and control of hypertension were found in this study. This highlights the urge to reinforce hypertension screening interventions and to strengthen educational programs on this disease with a focus on blood pressure monitoring and healthy lifestyle measures. Key messages Tunisian adults had a low level of awareness and control of hypertension. Reinforcing hypertension screening interventions and increasing awareness about healthy lifestyle measures are recommended.
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