Computational realization of period analysis for monitoring cancer patient survival.
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Humans↗
Biomedical subjects
Olaf Gefeller
Publications and source records attributed to Olaf Gefeller.
Impact of repetitive manual materials handling and psychosocial work factors on the future prevalence of chronic low-back pain among construction workers.
OBJECTIVES: This study investigated the influence of manual stone and brick handling and psychosocial work factors on the risk of chronic low-back pain and describes the impact in terms of risk advancement period. METHODS: The Hamburg Construction Worker Study included a longitudinal study among 488 male construction workers. Adjusted prevalence ratios (PR) of chronic low-back pain (>3 months during the last 12 months) according to self-reported worktasks in the baseline survey were estimated with the Cox proportional hazards model. RESULTS: The 1-year prevalence of chronic low-back pain was 15.4%. Workers with chronic low-back pain in the baseline survey had a higher risk of such pain during the follow-up (PR4.07,95% CI 2.18-7.59). The prevalence in association with laying large lime sandstones for >2 hours per shift (PR 1.80, 95% CI 1.04-3.14) further increased after adjustment for job category (PR 2.69, 95% CI 1.25-5.78), and it advanced the risk by a risk advancement period of 18 years (95% CI 4-39). Workers with low satisfaction with their work achievements had a higher prevalence of chronic low-back pain (PR 2.07, 95% CI 1.10-3.88). Similar risk estimates were observed in the subgroup without chronic low-back pain in the baseline survey. A strong effect of time pressure wasonly present for these workers (high: P R 6.30,95% CI 1.41-28.21). CONCLUSIONS: The results suggest that repetitive work involving bent positions and the manual manipulation of heavy stones increases the risk of future chronic low-back pain. For risk communication, the notion that a 40-year-old construction worker laying large sandstones has the same risk as an unexposed 58-year-old construction worker may be more informative.
Achievement↗
Erythropoietin therapy for acute stroke is both safe and beneficial.
BACKGROUND: Erythropoietin (EPO) and its receptor play a major role in embryonic brain, are weakly expressed in normal postnatal/adult brain and up-regulated upon metabolic stress. EPO protects neurons from hypoxic/ ischemic injury. The objective of this trial is to study the safety and efficacy of recombinant human EPO (rhEPO) for treatment of ischemic stroke in man. MATERIALS AND METHODS: The trial consisted of a safety part and an efficacy part. In the safety study, 13 patients received rhEPO intravenously (3.3 X 10(4) IU/50 ml/30 min) once daily for the first 3 days after stroke. In the double-blind randomized proof-of-concept trial, 40 patients received either rhEPO or saline. Inclusion criteria were age <80 years, ischemic stroke within the middle cerebral artery territory confirmed by diffusion-weighted MRI, symptom onset <8 hr before drug administration, and deficits on stroke scales. The study endpoints were functional outcome at day 30 (Barthel Index, modified Rankin scale), NIH and Scandinavian stroke scales, evolution of infarct size (sequential MRI evaluation using diffusion-weighted [DWI] and fluid-attenuated inversion recovery sequences [FLAIR]) and the damage marker S100ss. RESULTS: No safety concerns were identified. Cerebrospinal fluid EPO increased to 60-100 times that of nontreated patients, proving that intravenously administered rhEPO reaches the brain. In the efficacy trial, patients received rhEPO within 5 hr of onset of symptoms (median, range 2:40-7:55). Admission neurologic scores and serum S100beta concentrations were strong predictors ofoutcome. Analysis of covariance controlled for these two variables indicated that rhEPO treatment was associated with an improvement in follow-up and outcome scales. A strong trend for reduction in infarct size in rhEPO patients as compared to controls was observed by MRI. CONCLUSION: Intravenous high-dose rhEPO is well tolerated in acute ischemic stroke and associated with an improvement in clinical outcome at 1 month. A larger scale clinical trial is warranted.
Blood Platelets↗