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[Some occupational determinants of work disability].

Occupational determinants play a significant role in the studies of the causes of work disability. The duration of employment is that particular variable, frequently analysed, which reflects indirectly the effect of work conditions on the worker's health state and also on his her disease-related work disability. Therefore, the aim of this work was to show the difference in sick absenteeism between various occupational groups, depending on the duration of employment. The empirical material embraced data on work disability, among workers employed in the automative industry plant during the years 1989-94. Out of 8,599 persons covered with the study, 77% left the job, including 7% of those who left the job because of health problems. An analysis of the impact of occupational determinants on the sick absenteeism was carried out on the basis of the absenteeism rate adjusted by age, sex and occupational activity in groups of the production, auxilliary and administrative workers, as well as in occupational groups exposed to possibly similar harmful factors. The duration of worker's employment in the plant showed a positive influence on sick absenteeism, since together with extended period of employment the decrease in the rate of general sick absenteeism was observed. However, in a number of disease categories an increase in absenteeism together with extended duration of employment, and a high level of absenteeism among workers involved directly in the production, were noted. This proves an adverse effect of work conditions on work disability among workers. The effect of harmful factors present at workposts is also confirmed by the increasing sick absenteeism together with the prolonged duration of employment in various occupational groups. In the group of welders the highest level of sick absenteeism was observed among persons with duration of employment ranging from 11 to 20 years (rate: 10.52), and it was related to diseases of the respiratory (3.10) and circulatory (2.09) systems. In this group the increase in absenteeism together with prolonged duration of employment was related to diseases of the genitourinary system (about fourfold), musculoskeletal system (about threefold) and nervous system and sense organs (about 20%). It may be concluded that in selected high risk occupational groups, the duration of employment may reflect the effect of work conditions on workers' sick absenteeism, and the analysis of work disability caused by individual diseases provides an image of health effects due to hazards to which those groups are exposed.

Absenteeism↗

[Risk, cause and disease in the occupational environment. Neurologic risk factors].

OBJECTIVE: In this paper we study the epidemiological criteria and those of etiological investigation which should be considered when analysing and investigating problems with health due to exposure to occupational hazards, with special attention to neurological damage due to chemical or physical contamination or to the ergonometric requirements of the task. DEVELOPMENT: We define the part played by occupational hazards in causing disease both professional and related to other occupations. The different preventive models used in the history of prevention of professional hazards are analysed. Particular attention is paid to the so-called socio-technical model which considers illness as dysfunction of the relation man/work. The neurological risk factors are analysed separately; therefore we emphasize the different neurotoxic chemicals, physical and ergonomic agents (the latter may be considered a pandemic in the workplace), and we establish the relationships with the main clinical and functional disorders of the central and peripheral nervous systems and the musculoskeletal system.

Causality↗

[Ergonomics aspect and musculoskeletal symptoms in a transport sector].

The aim of the present study was to identify the tasks ranked as the most stressful and to investigate the ocurrence of musculoskeletal symptoms among workers employed by a patient transport sector. The RPE (Rating of Perceived Exertion) scale of Borg was used to determine the rating of perceived physical exertion on the musculoskeletal system. Measures of musculoskeletal disorders was obtained using a modified version of the Nordic Questionnaire. The workers felt that all of the tasks related to patient transfer require intense physical exertion, with scores from 16.8 to 13.8. The workers reported high musculoskeletal complaints in several body regions, with highest prevalence in the low back.

Adult↗

[Magnetic resonance in oncology].

The physical and biological background to magnetic resonance imaging (MRI) in patients with neoplasms is reviewed. The clinical indications for this method of diagnosis, staging, and follow-up of malignant neoplasms are discussed on the basis of the guidelines given by the MRI Consensus Conference on April 25-26, 1989, in Berne. MRI is the modality of choice in patients with neoplasms of the central nervous system and the musculoskeletal system. Further emerging indications for MRI are neoplasma of the ENT region, liver, and pelvic organs. Finally, the foreseeable developments in MRI and in magnetic resonance spectroscopy (MRS) are mentioned.

Abdominal Neoplasms↗

Lyme disease: the latest great imitator.

Lyme disease is caused by the spirochete B. burgdorferi. Like its counterpart syphilis, it causes multisystem disease particularly affecting the skin, nervous system, heart and musculoskeletal system. It is endemic in several areas of the United States as well as in Europe. The prompt recognition of this disease and its diverse manifestations should lead to early treatment and resolution. Prevention is aimed at avoidance of the tick vector.

Animals↗

Musculoskeletal problems at an accident and emergency department, and in general practice.

A retrospective study of the numbers and range of musculoskeletal conditions presenting to the accident and emergency (A and E) department of a general hospital over two one-week periods, in February and May 1980 is described. Over a third of the patients had musculoskeletal disorders most commonly affecting the hand (19%), ankle (13%), foot (9%) and spine (8%). One in three cases involved fracture. As judged by a physiotherapist, only 20% of cases which should have been referred for physiotherapy were actually referred. The frequency and range of musculoskeletal conditions encountered in general practice, and the undergraduate curriculum for the musculoskeletal system at the Auckland Medical School is reviewed. Postgraduate education in the musculoskeletal system is essential where emphasis should be given to conditions of the hand and the spine.

Bone Diseases↗

The impact of childhood obesity on musculoskeletal form.

Despite the greater prevalence of musculoskeletal disorders in obese adults, the consequences of childhood obesity on the development and function of the musculoskeletal system have received comparatively little attention within the literature. Of the limited number of studies performed to date, the majority have focused on the impact of childhood obesity on skeletal structure and alignment, and to a lesser extent its influence on clinical tests of motor performance including muscular strength, balance and locomotion. Although collectively these studies imply that the functional and structural limitations imposed by obesity may result in aberrant lower limb mechanics and the potential for musculoskeletal injury, empirical verification is currently lacking. The delineation of the effects of childhood obesity on musculoskeletal structure in terms of mass, adiposity, anthropometry, metabolic effects and physical inactivity, or their combination, has not been established. More specifically, there is a lack of research regarding the effect of childhood obesity on the properties of connective tissue structures, such as tendons and ligaments. Given the global increase in childhood obesity, there is a need to ascertain the consequences of persistent obesity on musculoskeletal structure and function. A better understanding of the implications of childhood obesity on the development and function of the musculoskeletal system would assist in the provision of more meaningful support in the prevention, treatment and management of the musculoskeletal consequences of the condition.

Adult↗

Plyometric exercise in the rehabilitation of athletes: physiological responses and clinical application.

Plyometric exercise was initially utilized to enhance sport performance and is more recently being used in the rehabilitation of injured athletes to help in the preparation for a return to sport participation. The identifying feature of plyometric exercise is a lengthening of the muscle-tendon unit followed directly by shortening (stretch-shortening cycle). Numerous plyometric exercises with varied difficulty and demand on the musculoskeletal system can be implemented in rehabilitation. Plyometric exercises are initiated at a lower intensity and progressed to more difficult, higher intensity levels. The progression to higher-intensity plyometric exercise is thought to resolve postinjury neuromuscular impairments and to prepare the musculoskeletal system for rapid movements and high forces that may be similar to the demands imposed during sport participation, thus assisting the athlete with a return to full function. While there is a large body of scientific literature that supports the use of plyometric exercise to enhance athletic performance, evidence is sparse regarding the effectiveness of plyometric exercise in promoting a quick and safe return to sport after injury. This review will describe the mechanisms involved in plyometric exercise, discuss the considerations for implementing plyometric exercise into rehabilitation protocols, examine the evidence supporting the use of plyometric exercises, and make recommendations for future research.

Adaptation, Physiological↗

Temporomandibular disorders, head and orofacial pain: cervical spine considerations.

Head and orofacial pain originates from dental, neurologic, musculoskeletal, otolaryngologic, vascular, metaplastic, or infectious disease. It is treated by many health care practitioners, such as dentists, oral surgeons, and physicians. The article focuses on the nonpathologic involvement of the musculoskeletal system as a source of head and orofacial pain. The areas of the musculoskeletal system that are reviewed include the temporomandibular joint and muscles of mastication--collectively referred to as temporomandibular disorders (TMDs) and cervical spine disorders. The first part of the article highlights the role of physical therapy in the treatment of TMDs. The second part discusses cervical spine considerations in the management of TMDs and head and orofacial symptoms. It concludes with and overview of the evaluation and treatment of the cervical spine.

Cervical Vertebrae↗

[Transplantation in orthopedic surgery and traumatology].

Clinical applications of the musculoskeletal system tissue bank are currently enlarging in areas such as tumour surgery, spine surgery and arthrodesis, reconstructive procedures of the hip joint and ligament repair. We report our experience about the use of more than 1,000 grafts utilize from 1987 to 1992. We concluded that a bone bank or a musculoskeletal system tissue bank has a great usefulness in different reconstructive surgery technics and arthrodesis. They are used more frequently in orthopaedic and traumatology surgery improving the development of this surgery.

Bone Neoplasms↗

New horizons in applied musculoskeletal research.

Are you prey to information overload? Do you wonder how you can determine what is useful for your purposes? Do you wonder about the relevance of some articles to your particular discipline? Nowadays, the explosion of information presents problems, perhaps nowhere as significantly as in the fields of the theoretical and applied sciences. Perhaps you are a clinician, an expert in the pathology of and injuries to the musculoskeletal system, needing to keep your clinical practice up to date with relevant new information. Assuming that your interest lies in the clinical application of ideas, Calcified Tissue International can help you resolve any confusion by focusing on modern topics that are of major clinical relevance, for example, improvement of the mechanical properties of the bone, especially in metabolic bone diseases, fracture healing enhancement, bone biological responses at the bone implant interface, musculoskeletal system interactions, the genetic bases of orthopedic disorders, and the possible orthopedic applications of gene therapy.

Arthroplasty↗

Musculoskeletal imaging with computed tomography and magnetic resonance imaging: when is computed tomography the study of choice?

Indications for computed tomography (CT) of the musculoskeletal system, especially with the advent of 16-slice multidetector CT (MDCT), are numerous. In addition to the evaluation of the trauma patient where CT is essential when imaging complex skeletal injuries, MDCT is particularly useful in patients who have had prior surgery. In postoperative cases, metal artifact typically prohibits magnetic resonance imaging evaluation, but volume-rendering of a MDCT axial database virtually eliminates streak artifact associated with hardware. For the evaluation of masses, CT provides the ability to detect and characterize calcification, cortical disruption, and periosteal reaction. In this article, these and other indications for performance of CT of the musculoskeletal system will be discussed.

Humans↗

Orthopaedic manifestations of systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease of unknown origin. It affects multiple organ systems, but most frequently the musculoskeletal system. Highly variable manifestations include small and large joint involvement, spinal involvement, periarticular tissue symptoms, and complications associated with chronic steroid use such as osteonecrosis, osteoporosis, and stress fractures. The following review summarizes the common orthopaedic manifestations of SLE.

Humans↗

Artifacts in musculoskeletal magnetic resonance imaging: identification and correction.

A large number of artifacts occur in magnetic resonance (MR) imaging of the musculoskeletal system. These artifacts may potentially affect the quality of MR images, and may also simulate pathologic conditions and produce pitfalls in interpretation. Motion artifacts may be periodic or random. Protocol-error artifacts include saturation, wraparound, radiofrequency (RF) interference, shading, and partial volume averaging artifacts. Truncation artifacts occur when the number of phase-encoding steps of high spatial frequencies is insufficient (or under-sampled) for faithful reproduction of the true anatomic detail of the original image. Chemical shift artifacts are due to the protons in fat being mismapped relative to water protons. Susceptibility artifacts occur at the interfaces of structures with different magnetic susceptibilities. Artifacts special to the musculoskeletal system include the magnic angle phenomenon and spurious signal induced at very short echo times, both of which affect anisotropic structures such as tendon, ligament, and cartilage. Recognition and, if possible, correction of these artifacts are an important aspect of practical musculoskeletal MR imaging.

Artifacts↗

Beta thalassaemia: a report of 20 children.

Beta-thalassaemias have a wide variety of musculoskeletal system manifestations. In this cross-sectional study, we aimed to investigate the frequency and features of musculoskeletal system problems in children with beta-thalassaemia. A total of 20 beta thalassaemic patients with an average age of 13.8 years were enrolled in the study. In all patients studied, detailed history regarding musculoskeletal involvement was taken and locomotor examinations were performed. All patients underwent radiographic examination with standing anteroposterior and lateral X-rays of the spine. Two physicians blinded for the diagnosis used Cobb technique for determining the degree of scoliosis. In 12 of 20 patients (60%) locomotor system involvement was found. Most frequent complaints were arthralgia and low back pain in 30% and 25% of patients respectively. Scoliosis was detected radiologically in 40% of patients with a lateral curve of at least 5 degrees Cobb.

Adolescent↗

Infectious arthropathies and other rheumatologic manifestations of infectious diseases.

Infectious agents have been implicated in the pathogenesis of many rheumatologic diseases. In most of these diseases, including those in which specific organisms are known to play a role, the details of pathogenesis remain incompletely defined. Recent studies have aimed to isolate bacterial and viral pathogens from patients with rheumatic diseases, efforts have been made to further define the host immune response to infection, and there have been attempts to develop improved methods of diagnosis and treatment of infectious diseases affecting the musculoskeletal system. This review discusses recent studies on the association of infection with illnesses affecting the joints and musculoskeletal system, with an emphasis on the rheumatic diseases of childhood.

Arthritis, Infectious↗

Musculoskeletal mechanics: a foundation of motor physiology.

The design of the musculoskeletal system has always been a major consideration in the interpretation of experiments on the motor system. However, as motor physiology progresses toward a more comprehensive picture of motor behaviour, the study of the musculoskeletal system has of necessity, and of interest, come to depend more and more on the quantitative methods of biomechanics. Biomechanical studies have led to new hypotheses about the design of the motor system and biomechanical considerations have provided important tests of existing hypotheses concerning the neural control of movement. These hypotheses include global issues such as redundancy and encoded variables as well as specific hypotheses such as Stiffness Regulation, Selective Recruitment and the concept of Flexor Reflex Afferents.

Animals↗