Association between plasma testosterone and work-related neck and shoulder disorders among female workers.
(49/1401)
OBJECTIVES: The aims were to study the association between anabolic hormone testosterone in plasma and the presence of musculoskeletal disorders among female workers and to study the association between changes in testosterone and changes in musculoskeletal complaints. METHODS: In a cross-sectional design 145 women from 2 different industries filled out questionnaires about current musculoskeletal complaints, participated in a clinical examination of the neck and upper extremities, and gave a blood sample for the analysis of free testosterone in plasma. Individual characteristics, psychosocial job factors, and stress reactions were evaluated by questionnaires. In a follow-up study a subgroup of 73 sewing machine operators from the cross-sectional study was reexamined after 1 year. RESULTS: The group of women with clinically verified neck or shoulder disorders had significantly lower plasma testosterone than the women with no disorders. Furthermore, the testosterone level showed a negative association with age and a positive association with smoking and body mass index. Changes in pain status or clinically diagnosed musculoskeletal disorders were not associated with changes in testosterone levels. However, this finding may well be due to a strong plant influence in that marked changes in testosterone levels were observed for 2 of the 3 participating plants. CONCLUSIONS: There is some indication of an association between musculoskeletal disorders in the neck and shoulders and a low level of free plasma testosterone. The study failed to clarify the associations found between changes in testosterone and changes in musculoskeletal complaints over time. (+info)
Acute response to precision, time pressure and mental demand during simulated computer work.
(50/1401)
OBJECTIVES: The electromyographic (EMG) activity of shoulder and forearm muscles was recorded during a standardized computer task with different combinations of time pressure, precision demands, and mental demands to study the interaction of these factors and their effect on muscular response during simulated computer work. METHODS: The computer task lasted 5 minutes, and it was performed by 14 female computer-aided design (CAD) operators during 8 exposure combinations that differed with respect to time pressure, precision demand, and mental demand. Performance (number of produced drawings, mouse clicks, and errors) were recorded. The EMG activity was recorded from the trapezius, infraspinatus, deltoid, and extensor digitorum muscles. An electrogoniometer was used to measure wrist postures and movements. RESULTS: High time pressure (combined with low precision and low mental demands) resulted in higher EMG activity for all the muscles and in a small increase in the number of produced drawings. High precision demands caused a large reduction in the number of produced drawings, but not always a change in EMG activity. High precision demands and high mental demands led to no change or a reduction in muscle activity because the number of drawings was greatly reduced. CONCLUSIONS: The interaction between work pace and other exposure factors must be taken into account when the effects of changes in exposure demands on muscular response are predicted. Only then can it be predicted whether changing demands will constitute a risk of developing musculoskeletal disorders. (+info)
A population study of factors associated with general practitioner consultation for non-inflammatory musculoskeletal pain.
(51/1401)
OBJECTIVE: To investigate factors associated with visiting a general practitioner (GP) for non-inflammatory musculoskeletal pain, and to examine whether these factors were affected by duration (chronic v non-chronic) or location (widespread v regional) of pain. METHODS: From a cross sectional postal survey of 20 000 (response rate 59%) randomly selected adults in two counties of Norway, 6408 subjects who had experienced musculoskeletal pain during the past month were included. Patients who reported inflammatory rheumatic diagnoses made by a doctor were excluded. RESULTS: 2909 (45%) had consulted a GP for their musculoskeletal pain during the past 12 months. The odds of consulting were significantly increased by being a woman, by having a higher age and lower education, and by being a pensioner or on sick leave. Patients with widespread pain were more likely to consult than those with regional pain, as were patients with chronic compared with non-chronic pain. Greater than median pain intensity was the factor most prominently associated with consultation for men (odds ratio (OR)=2.4; 95% confidence interval (95% CI) 2.0 to 2.9) and for women (OR=2.6; 95% CI 2.3 to 2.9). Overall, consultation was significantly associated with mental distress for women but not for men. Subgroup analyses showed that consultation for chronic pain was significantly associated with greater than median mental distress for both women (OR=1.3; 95% CI 1.1 to 1.6) and men (OR=1.2; 95% CI 1. 0 to 1.4), whereas consultation for non-chronic pain was not. CONCLUSION: The results show that about half of the patients with musculoskeletal pain consult a general practitioner (GP) each year, that demographic factors are associated with consulting, and that the role of mental distress for consulting a GP varies with duration of pain. (+info)
Musculoskeletal manifestations of bacterial endocarditis.
(52/1401)
CONTEXT: The incidence of staphylococcal infection has been increasing during the last 20 years. OBJECTIVE: Report a case of staphylococcal endocarditis preceded by musculoskeletal manifestations, which is a rare form of clinical presentation. DESIGN: Case report. CASE REPORT: A 45-year-old-man, without addictions and without known previous cardiopathy, was diagnosed as having definitive acute bacterial endocarditis due to Staphylococcus aureus. Its etiology was community-acquired, arising from a non-apparent primary focus. In addition, the musculoskeletal symptoms preceded the infective endocarditis (IE) by about 1 month, which occurred together with other symptoms, e.g. mycotic aneurysms and petechiae. Later, the patient showed perforation of the mitral valve and moderate mitral insufficiency with clinical control. (+info)
Measuring and characterizing force exposures during computer mouse use.
(53/1401)
OBJECTIVES: The purpose of this study was to develop and validate a sampling strategy for characterizing the finger force exposures associated with computer mouse use. METHODS: Mouse forces were measured from 16 subjects (8 men, 8 women), on 3 separate days, at their actual workstations while they performed (i) their regular work, (ii) a battery of standardized tasks, and (iii) simulated mouse use. RESULTS: The forces applied to the mouse did not vary between hours or days. During regular work, the mouse was used 78.0 (SD 40.7) times per hour, accounting for 23.7 (SD 9.5)% of the worktime. The mean forces applied to the sides and button of the mouse were low, averaging 0.6 % (0.35 N) and 0.8 % (0.43 N) of the maximal voluntary contraction, respectively. The forces applied to the mouse during the standardized tasks differed from the regular work forces; however, there were moderate-to-strong correlations between the 2 measures. CONCLUSIONS: With respect to performing exposure assessment studies, the 3 major findings were (i) mouse force measurements should be made while subjects perform their actual work in order to characterize the absolute applied force accurately, (ii) the forces applied to the mouse during the performance of a short battery of standardized tasks can be used to characterize relative exposure and identify computer operators or work situations for which higher forces are applied to the mouse, and (iii) subjects cannot accurately simulate mouse forces. (+info)
Misclassification of physical work exposures as a design issue for musculoskeletal intervention studies.
(54/1401)
OBJECTIVES: This study determined the impact of misclassification due to using job titles as surrogate variables for physical work exposures to assess confounding in a study of the preventive effect of back belts on back injury. The authors present retail merchandise data that quantify misclassification from residual confounding by physical work exposures on injury rate ratios when available administrative job titles are used. METHODS: Job title and direct observation data on 134 workers were used to calculate the percentage to which the job-title-adjusted rate ratio for back injury accounts for confounding by the true physical work exposures, awkward postures, and heavy weight handling. Workers' compensation data, an estimate of the effect of back belts from the literature, and the percentage of adjustment of the rate ratio due to the job title variable were used to calculate the magnitude of bias from the rate ratio adjusted for job title. RESULTS: The job title variable was found to have sensitivities of 97% and 85% and specificities of 68% and 58% for awkward postures and heavy weight handling, respectively. The magnitude of confounding bias remaining for the back-injury rate ratio when the job title surrogate was used was 24% for postures and 45% for heavy weight handling. CONCLUSIONS: The administrative job title performed poorly in this setting; residual confounding was sufficient to bias the rate ratio from 2.0 to 1.3. The effect of additional sources of misclassification and the need for better exposure measures than job title are discussed. (+info)
Role of color Doppler sonography in the assessment of musculoskeletal soft tissue masses.
(55/1401)
Fifty-six patients with soft tissue masses of the limbs (36 benign, 20 malignant) prospectively underwent sonography (color Doppler and pulsed Doppler examinations) to assess the role of Doppler interrogation in differentiating benign from malignant lesions. Sonography showed 60% sensitivity, 55% specificity, 71% negative predictive value, 42% positive predictive value, and 57% accuracy. Color Doppler evaluation showed 85% sensitivity, 88% specificity, 91% negative predictive value, 80% positive predictive value, and 87% accuracy. Diastolic and venous velocities and pulsatility index values were not statistically significant. Mean systolic velocity was 0.27 m/s in benign lesions and 0.55 m/s in malignant lesions. By combining sonographic and Doppler data, a correct diagnosis was obtained in 51 of 56 patients (90% sensitivity, 91% specificity, 85% positive predictive value, 94% negative predictive value, 91% accuracy). Color Doppler and pulsed Doppler evaluations represent a useful adjunct to sonography and should be routinely included in the evaluation of musculoskeletal soft tissue masses by ultrasonography. (+info)
Improving patient satisfaction with time spent in an orthopedic outpatient clinic.
(56/1401)
OBJECTIVE: To determine if patient satisfaction can be improved by changing patients' expectations of the clinic visit and by decreasing the total time spent in the clinic. DESIGN: A prospective comparative analysis carried out in 4 phases. SETTING: An university-affiliated orthopedic outpatient clinic. PATIENTS: All patients seen in the orthopedic outpatient clinic were eligible. Phase 1 determined the total clinic time required by patient type; phase 2 assessed baseline satisfaction; phase 3 altered patients' expectations; and phase 4 altered patients' expectations and scheduled visits by patient type. INTERVENTION: Patient questionnaires. MAIN OUTCOME MEASURE: Patient satisfaction with time spent in the clinic. RESULTS: Of 708 distributed questionnaires, 622 (88%) were completed (547 totally complete, 75 partially complete). Total time spent in the clinic decreased across phases 2, 3 and 4 (mean 99.2, 94.7 and 85.2 minutes, respectively, but was significantly different only between phases 3 and 4; p = 0.05, Duncan's multiple range test). The percentage of patients who rated their waiting time as "excellent" increased across phases 2, 3 and 4 (14.6%, 18.8% and 31.1%, respectively; p = 0.0004, chi 2 test). CONCLUSION: Patient satisfaction can be improved by altering patient expectations and by decreasing the total time spent in clinic. (+info)