Sixty seven infantile patients developing postoperative phlogistic complications as a consequence of posterior fossa surgery (i.e.: neoplasms, arachnoid cysts, A-V malformations) are herein studied. They have been subdivided in 2 groups in accordance to the different preoperative diagnostic procedures they underwent. In the first series 41 cases of posterior fossa anomalies have been diagnosed by means of air contrast ventriculography with or without cerebral angiography; in the other one the 26 patients were submitted to C.A.T. with or without angiography. In the first group the incidence rate of phlogistic complications was 31.7%, in the second one 3.8%. According to the authors this considerable difference is due to the diagnostic procedures employed. Contraindications to air contrast ventriculography and advantages of CT scan are widely discussed and emphasized.

Arachnoid↗

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[Further experience with a new method for risk evaluation in work postures (author's transl)].

Explore the source record for details and available documents.

Adult↗

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[Thoracic outlet syndrome. Clinico-instrumental aspects of 36 cases].

The authors report their experience on 36 cases of thoracic tunnel syndrome. They deal with the nosographic arrangement of neurovascular syndromes of the upper limbs. Within the framework of the casuistics 13 patients were operated: the authors present clinical and E.M. Graphic criteria on the ground of which it was decided to operate. Results appear to be positive as to subjective symptomatology; they are less positive as to the objective one.

Angiography↗

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[Back pain in health care workers].

Back pain is a major health and economic problem for preventive medicine. It has been found to be significantly associated with nursing. The present paper reviews a number of epidemiological studies on back pain in nurses and examines the main confounding factors. The different approaches to back pain prevention are briefly discussed.

Back Pain↗

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[Diseases of the dorsal-lumbar spine and manual handling of loads: guidelines for fitness assessment].

In occupational medicine, degenerative diseases and malformations of the spine are one of the main reasons for requests for fitness assessment for specific jobs, especially among workers involved in manual handling tasks. By means of a selected review of the specialised literature, the authors identify analysis procedures and precise criteria for assessing compatibility between the clinical condition of the spine and manual handling tasks. Attention is drawn in particular to the diseases caused or at least aggravated by mechanical overloading of the spine. For each of these a set of diagnostic criteria is established which could be useful in defining the various levels of severity. On another front, by using tried and tested methods and criteria to identify the weight limits that can be lifted by healthy subjects in various manual handling situations, an approach was developed that can be applied to establish the weight limits that can be lifted by subjects with spinal diseases. By combining the two factors, risk level and damage level, a set of disorders was established that correspond to three different fitness levels. At each level, manual load handling was only allowed up to certain weights and for handling conditions that became increasingly stringent as the severity of the disorder increased. The paper outlines the clinical protocols and the protocols for reconstructing work exposure. The procedural differences involved in the case of fitness assessments in the pre-employment stage are also briefly discussed.

Female↗

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[Epidemics of musculotendinous pathologies of the upper limbs (cumulative trauma disorders) in a group of assembly line workers].

The study was prompted by a report concerning a group of assembly line workers in a factory producing prams who had developed various muscular and tendinous disorders of the upper limbs that can be classified under the larger category of Cumulative Trauma Disorders (CTD). The study first concentrated on the working conditions with analysis of the main factors responsible for overloading of the upper limbs during work. This analysis revealed high frequency and repetitiveness of upper limb movements together with a marked inadequacy of the length and distribution of pauses. In a significant part of the operations the workers also performed movements in positions that over loaded the wrist and hand. A parallel clinical and instrumental study carried out in collaboration with specialists in orthopedics, brain surgery and neurophysiology on all 40 workers in the shop showed that 90% of the subjects suffered from a form of CTD of the upper limbs: in particular, 40% were affected with carpal tunnel syndrome (12.5% bilateral), and there were high prevalence of tenosynovitis (32% Trigger Finger, 17% De Quervain's syndrome) and epicondylitis (20% medial or lateral). The results of the study once again emphasize the need for greater attention of occupational health practitioners in Italy for muscular and tendinous disorders of the upper limbs due to repeated strain, which Italian law defines, albeit controversially, as occupational.

Adult↗

PubMedDate not supplied

Criteria for the ergonomic evaluation of work chairs.

UNLABELLED: On the basis of a critical overview of specialised ergonomics literature and of national and international standards on the subjects, this paper outlines the main ergonomic requirements and characteristics for work chairs. The main ergonomic requirements for work chairs are the following: SAFETY: the chair should not be the source or cause of accidents. Adaptability: the chair's dimensions and control features should be such that they meet the anthropometric characteristics of at least 90% of the potential users. Comfort: the chair should be physiologically comfortable for the user. To this end, the following are all important features: seat-plane and backrest contours, backrest height and inclination adjustability, padding and covering materials that allow the body to breath. Practicality: the chair, and in particular the control features, should be practical and easy to control use. Durability: the chair should offer good wear and durability of its components and controls. Suitability for the job: the chair should be appropriately designed for the intended type of job and working environment. For each of these requirements single parameters are considered and for each parameter specific qualitative and/or quantitative data are given in order to class each single item as: "not acceptable", "acceptable" or "good", as regards standards and regulations, anthropometric parameters and intended uses. Criteria are given for a concise assessment of each of the six main requirements and for a comprehensive assessment of the "ergonomic quality" of the work chair.

Adult↗

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[Musculoskeletal disorders of upper extremities caused by biomechanical overload: methods and criteria for the description of occupational exposure].

This article presents and discusses a model for describing and evaluating the principal risk factors characterising occupational exposure: frequency and repetitiveness of movements, use of force, type of posture and movements, distribution of recovery periods, presence of other influential (complementary) factors. For each risk factor, the authors propose a method of practical detection in the field, as well as criteria for classifying and interpreting the results based on a critical review of the available literature on the subject. Numerous examples are supplied to better illustrate the concepts presented. The various factors considered are classified using numbers or indexes, so that they can be integrated into a concise exposure index described by the authors elsewhere in this volume.

Arm↗

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[Proposal of a concise index for the evaluation of the exposure to repetitive movements of the upper extremity (OCRA index)].

In the light of data and speculation contained in the literature, and based on procedures illustrated in a previous research project in which the authors describe and evaluate occupational risk factors associated with work-related musculoskeletal disorders of the upper limbs (WMSDs), this article proposes a method for calculating a concise index of exposure to repetitive movements of the upper limbs. The proposal, which still has to be substantiated and validated by further studies and applications, is conceptually based on the procedure recommended by the NIOSH for calculating the Lifting Index in manual load handling activities. The concise exposure index (OCRA index) in this case is based on the relationship between the daily number of actions actually performed by the upper limbs in repetitive tasks, and the corresponding number of recommended actions. The latter are calculated on the basis of a constant (30 actions per minute) which represents the action frequency factor, and is valid-hypothetically-under so-called optimal conditions; the constant is diminished case by case (using appropriate factors) as a function of the presence and characteristics of the other risk factors (force, posture, complementary elements, recovery periods). Although still experimental, the exposure index can be used to obtain an integrated and concise assessment of the various risk factors analysed, and to classify occupational scenarios featuring significant and diversified exposure to such risk factors.

Analysis of Variance↗

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[Clinical studies in working populations: a model for the anamnestic investigation of the pathology of the upper limbs and its practical application].

Following a brief review of the principal clinical characteristics of musculo-skeletal disorders of the upper limbs, the authors propose a protocol for a structured anamnestic examination featuring a series of set questions. The anamnestic model is based on a detailed listing of the symptoms to be analysed, which are divided into four categories: pain, paraesthesia, symptoms attributable to hyposthenia, and neurovegetative disorders. Regarding pain and paraesthesia, the authors list the localisation, pattern of onset, duration and number of episodes, irradiation, and treatment. The patients can thus be classified as anamnestic cases based on the following criteria: presence of pain or paraesthesia during the last 12 months, with episodes lasting for at least one week, or occurring at least once a month, with no previous acute trauma. For hyposthenia, the authors report on the conditions under which the disorder may develop. The neurovegetative disorders considered are modifications in colour of the fingers and reaction to exposure to low temperatures. The structure of the proposed anamnestic chart permits all findings to be easily encoded for subsequent storage in a dedicated database. The Appendix contains an annotated facsimile of the anamnestic chart.

Arm↗

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[Clinical studies in working populations: value and significance of anamnestic findings, clinical tests and instrumental tests for the diagnosis of musculoskeletal disorders of the upper extremities].

The authors discuss the value and significance of symptoms in WMSDs, considering that the anamnestic threshold proposed in epidemiological investigations cannot be used as clinical and diagnosing criteria. Some useful clinical procedures are suggested for cases where there is a suspicion of musculo-skeletal disorders of the cervical spine and upper limbs, bearing in mind that they are to be applied within the framework of health surveillance programmes undertaken by health care practitioners who are not specialists in orthopaedics, physiatrics or neurology. The recommendations for instrumental tests and specialist referrals are also discussed for the various disorders. The authors also provide flow charts for the diagnostic procedures pertaining to WMSDs. The Appendix shows a sample patient chart illustrating the proposed procedures; it also permits the findings to be encoded so that they can be stored in a dedicated database. The codes for diagnosing WMSDs are also reported for the same epidemiological purposes.

Arm↗

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[Occurrence of musculoskeletal disorders in working populations not exposed to repetitive tasks of the upper arms].

A total of 749 workers (males: 139 aged between 15 and 35 years, and 171 aged over 35 years; females: 176 aged between 15 and 35 years, and 263 aged over 35 years) performing tasks not at risk for work-related musculo-skeletal disorders of the upper limbs (WMSDs) underwent a clinical examination using a standardised method. The "anamnetics cases" were defined on the basis of pain or paraesthesia present for at least one week during the previous 12 months, or appearing at least once a month, and not subsequent to acute trauma. The anamnestic cases among the males amounted to 4.4% (age 15 divided by 35 years) and 12.3% (age > 35); among the females 4.6% (age 15 divided by 35 years) and 14.2% (age > 35). Of the 1498 limbs examined, the prevalent pathologies reported were: suspect narrow chest syndrome: 0.3% among the males > 35 years, 0.6% among the females aged 15 divided by 35 years, 1% among the females > 35 years; scapulo-humeral periarthritis: 0.3% among the males aged > 35 years, 0.3% among the females aged 15 divided by 35 years, 1.3% among the females aged > 35 years; lateral epicondylitis: 0.3% among the males aged > 35 years, 0.2% among the females aged > 35 years; trapezio-metacarpal arthrosis: 0.8% among the females aged > 35 years; wrist-hand tendinitis: 0.9% among the males aged > 35 years, 0.9% among the females aged 15 divided by 35 years; carpal tunnel syndrome: 2.5% among the females aged > 35 years. No disorders were detected outside of the age ranges indicated. Several workers reported more than one disorder. The number of workers with at least one WMSD was: males 0% in the 15 divided by 35 years age range, 3.5% in the > 35 year age range; females 2.3% in the 15 divided by 35 year age range, 7.2% in the > 35 year age range; 3.9% of the total sample population. The prevalences were on average quite low, particularly among the older workers, hence the authors recommend that even minimal prevalences detected in particular work environments should not be underestimated.

Adolescent↗

PubMedDate not supplied

[The application of the concise exposure index to repetitive movement tasks of the upper limbs in various production settings: preliminary experience and validation].

A summary of eight investigations is presented, which were carried out using standardised methods, for the purpose of quantifying exposure to tasks involving repetitive movements of the upper limbs, as well as quantifying the prevalence of Work Related Musculo Skeletal Disorders of the upper limbs in groups of exposed workers. A total of 462 exposed workers were examined, and the study also took into account the data pertaining to a matched control group comprising 749 workers not exposed to any specific occupational risk. Regarding the quantification of exposure to increased risk, use was made of a Concise Index (OCRA), proposed by the Authors in a previous publication. The data resulting from the eight investigations were used for the study of measurements and models of association among the exposure variables (mainly represented by the OCRA index), as well as the effect variables represented by the prevalence of the various WMSDs of the upper limbs taken both individually and jointly. Significant associations were reported between the OCRA index and an effect indicator represented by the prevalence of all the WSMDs of the upper limbs, calculated on the number of upper limbs at risk. When a logarithmic conversion of the relative exposure (OCRA) and injury indices was carried out, a simple linear regression model resulted which seems to provide a satisfactory predictive performance of the risk of WMSDs of the upper limbs, based on the exposure index. The study confirmed the efficacy of various other models designed to predict effects based on multiple linear regression functions, in which the independent variables are represented by both the OCRA exposure index and by parameters relative to the breakdown by sex and age of the groups of exposed workers.

Adult↗