OBJECTIVE:To assess the association between depression and chronic diseases in adults. METHODS:Population-based cross-sectional study with a sample of 1,720 adults aged 20 to 59 years conducted in the city of Florianópolis, southern Brazil, in 2009. Multistage sampling was used and census tracts were the primary sample unit. Subjects were interviewed at home, and reported being diagnosed with depression (outcome) and 11 other chronic diseases (exploratory variable) by a health provider. They were grouped into those with no chronic disease, one, and two or more diseases. Gender, age, marital status, income, physical activity, hospitalization and medical visits were confounders. Poisson regression analysis was used to estimate prevalence ratios and related 95% confi dence intervals. RESULTS:The prevalence os depression was 16.2% (95%CI 14.3;18.2). It was higher in women, older individuals, widowed or divorced, and poor ones. Those who reported no leisure-time physical activity and medical visits in the last two weeks, and who were hospitalized in the last year also showed higher prevalence of depression and chronic diseases. Even after adjustment for confounders the prevalence of depression was 1.44 (95%CI 1.09;1.92) times higher among those reporting one chronic disease and 2.25 times higher among those reporting two or more diseases than among those with no diseases. CONCLUSIONS:The prevalence of depression is much higher among people with higher burden of chronic diseases. Health professionals, health services, and policy makers must target specifi c strategies to this group.

Artigo disponível em português e inglês em: www.scielo.br/rsp Associação entre depressão e doenças crônicas: estudo populacionalAssociation between depression and chronic diseases: results from a population-based study RESUMO OBJETIVO: Analisar a associação entre depressão e doenças crônicas em adultos. MÉTODOS:Estudo transversal de base populacional com 1.720 adultos de 20 a 59 anos em Florianópolis, SC, em 2009. O processo de amostragem foi por conglomerados, sendo os setores censitários as unidades primárias de amostragem. Os participantes reportaram ter recebido ou não o diagnóstico de depressão (desfecho) e outras onze doenças crônicas (variável exploratória) por profi ssional de saúde. As respostas foram agrupadas em nenhuma doença, uma e duas ou mais doenças crônicas. Sexo, idade, estado civil, renda, atividade física, hospitalização e consulta médica foram as variáveis de controle. Foi realizada Regressão de Poisson para estimar as razões de prevalências e respectivos intervalos de confi ança (95%). RESULTADOS:A prevalência de depressão foi de 16,2% (IC95% 14,3%;18,2%), mais elevada entre mulheres, nos mais idosos, nos viúvos ou separados, nos mais pobres, entre os que não praticam atividade física no lazer, que consultaram médico nas duas últimas semanas e naqueles hospitalizados no último ano. Quanto ao número de doenças crônicas, mesmo após ajuste por todas as variáveis de controle, a prevalência de depressão foi 1,44 (IC95% 1,09;1,92) vez maior entre as pessoas que reportaram uma doença crônica e 2,25 (IC95% 1,72;2,94) vezes maior entre aqueles com duas ou mais doenças crônicas em relação às pessoas sem doença. CONCLUSÕES:A prevalência de depressão é expressivamente mais elevada entre pessoas com maior número de doenças crônicas, confi gurando-se esse grupo como de especial atenção por parte de profi ssionais de saúde, serviços e formuladores de políticas em relação ao seu acompanhamento.

BackgroundFemoroacetabular impingement syndrome (FAIS) is a highly prevalent painful disorder that is considered a risk factor for hip osteoarthritis. Confirming that FAIS is the main cause of a pain is a hard task. There are patients who have the typical morphological alterations of FAIS, but are asymptomatic. FAIS morphologies can represent a major confounding factor in patients with undiagnosed rheumatic diseases. On the other hand, surgery can significantly improve quality of life of patients with FAIS. Anesthetic intra-articular injections might constitute viable alternatives for diagnosing FAIS.ObjectivesThis systematic review aimed to answer the following question: “What is the diagnostic capability of anesthetic intra-articular hip injections for the assessment of FAIS?”.MethodsThis study was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) statement. Embase, CINAHL, LILACS, PubMed, SCOPUS, SPORTDiscuss, The Cochrane Library, and Web of Science databases were screened. All studies that assessed the diagnostic capability of anesthetic intra-articular hip injections for the assessment of FAIS were considered eligible. Study selection and data collection were performed by three independent reviewers. Risk of bias of the included studies was assessed through the QUADAS-2 tool.ResultsA total of 13 articles were selected for full-text reading, of which 5 were finally considered eligible and included for analysis [1-5]. A summary of the studies’ descriptive characteristics can be found in the Table 1. Overall judgment was “at risk of bias” for all included studies (Figure 1). More detailed information regarding bias assessment at QUADAS-2 is available in the Figure 1. From 5 included studies, only 2 [2,5] indicated that anesthetic intra-articular injections can be useful as diagnostic tools for FAIS.Figure 1.Table 1.AuthorMean AgeN (Female)Injection ContentInjection GuidanceTime for pain assessment after injection (Way of assessment)Threshold to consider FAIS diagnosisReference StandardFindingsKivlan29.9 ± 10.472 (54)Lidocaine + bupivacaine + triamcinoloneFluoroscopy2 hours (provocative activities)Not establishedArthroscopyNo difference in pain relief after injection between individuals with and without FAIS (p=0.128)Kraeutler38.8 ± 14.2161 (120)Lidocaine + triamcinoloneNon-guided10 minutes (physical tests and provocative activities)>70% of pain relief after injectionSymptoms + physical tests + radiographyFAIS and dysplasia diagnosed in 76% of patients with >70% of pain relief after injection, and in 67% in patients presenting <70% (p=0.62)Chinzei36.7 ± 14.749 (27)LidocaineFluoroscopy2 weeks (uninformed)>50% of pain reliefArthroscopyNo significant association between pain relief intensity after injection and the presence of FAIS (p>0.05)Gao36 (16-65)78 (41)Lidocaine + betamethasoneUltrasound10 minutes and 1 week (routine tasks)> 50% of pain reliefArthroscopyResponse to injection is 91.7% accurate for detecting FAISPerdikakis33 (18-58)34 (20)RopivacaineFluoroscopy30 minutes (physical tests)UninformedArthroscopyResponse to injection presented 92% of PPV and 96,5% of accuracy for diagnosing FAIS, with NPV and sensitivity of 100%ConclusionEvidence regarding the diagnostic capability of anesthetic intra-articular hip injections for FAIS is sparse. In order to accurately answer our research question, future studies that use standardized and optimized protocols of injection and pain assessment after injection are still essential. Furthermore, the need to take into account the different biases surrounding diagnostic studies was highlighted in our study.References[1]N Chinzei et al., Eur J Orthop Surg Traumatol 30 (4), 737 (2020)[2]G Gao et al., Arthroscopy 37 (1), 128 (2021)[3]BR Kivlan et al., Arthroscopy 27 (5), 619 (2011)[4]MJ Kraeutler et al., J Hip Preserv Surg 5 (3), 220 (2018)[5]E Perdikakis et al., Hell J Radiol 6 (2), 6 (2021)Disclosure of InterestsNone declared