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At least 829 records · Page 46Linked to original sources
PubMed1992

[The surgical restoration of the function of the knee joint in patients with severe refractory posttraumatic contractures].

Results of operative treatment of 100 patients with long-standing persistent contractures of the knee joint and partial defects of condyles of joint ends were studied. The treatment used allowed to obtain favorable results in majority of the patients and to return working ability to the patients. The application of perosseous apparatuses and allotransplantation make the potentialities of reconstructive surgery of the knee joint much wider.

Adult↗
PubMed1992

Pantalar and tibiotalocalcaneal arthrodesis for post-traumatic osteoarthrosis of the ankle and hindfoot.

Twenty-one patients had a unilateral extended arthrodesis of the ankle and hindfoot (a tibiotalocalcaneal procedure in thirteen patients and a pantalar procedure in eight) for post-traumatic osteoarthrosis or deformity, or both. The operation was performed through a transfibular extended lateral approach, and autogenous bone graft and rigid internal fixation was used. A final alignment of 0 to 5 degrees of valgus, 0 to 5 degrees of calcaneus, and external rotation equal to that of the contralateral side was sought. Subjective and objective evaluation, including a personal interview, physical examination, and radiographic and dynamic pedobarographic analysis, was performed at a mean interval of thirty-two months (range, twenty-four to fifty-four months) after the operation. A solid fusion was achieved in eighteen (86 per cent) of the twenty-one patients. There were five malunions (24 per cent) and two superficial wound problems (10 per cent). Of the seventeen patients who were not retired from work, eleven returned to work: nine to an occupation that involved standing and two to a sedentary occupation. Although seventeen (81 per cent) of the twenty-one patients reported that they were much improved, twenty (95 per cent) had some pain, and most benefited from modifications in shoe-wear. Patients who had had a tibiotalocalcaneal arthrodesis were more mobile and functioned at a higher level than those who had had a pantalar arthrodesis. Extended arthrodesis of the ankle and hindfoot is a complex, technically demanding procedure, and should be regarded as a salvage operation capable of producing a satisfactory result and usually providing a reasonable alternative to amputation.

Adult↗
PubMedDate not supplied

[Bladder cancer and occupational activity].

Bladder cancer is important in Occupational Medicine and in Occupational Epidemiology. Multicentric studies and pooled analysis have contributed in the last few years to the identification and characterization of several risk factors for bladder cancer, both occupational and non-occupational. Currently, it is a research priority the study of genetic susceptibility and its interaction with environmental and occupational exposure to the various bladder cancer risk factors. Bladder cancer management entails a few aspects that directly involved the Occupational Phisycian in different activities such as biological monitoring of chemicals, known or suspected bladder carcinogens, health surveillance, fitness for work, the return to work of the bladder cancer patients and finally epidemiological surveillance and health promotion.

Humans↗
PubMed1992

[Morbidity caused by industrial accidents in a health zone].

OBJECTIVE: The aim of the present study is to discover the morbidity produced by workplace accidents among the earning population of Molina de Segura Health Area. DESIGN: This was a descriptive crossover study. Site. The study was carried out in the Primary Care framework, in the Molina de Segura Health Area and with the collaboration of the Labour Health Unit of Insalud-Murcia. PATIENTS AND OTHERS PARTICIPANTS: Over a year a total of 774 cases of time off work due to workplace accidents, out of a total of 9,302 workers, were examined. 679 cases of workers resident in Molina de Segura were included in the study, whose time-off dates fell between July 1, 1989 and June 30, 1990 and where the company for which they worked was based or had its trading name located in Molina. MAIN MEASUREMENTS AND RESULTS: Of the total cases of time off work studied, 539 (79.4%) were men and 140 (20.6%) were women. The pathologies most often found were "blows, bruisings and crushings" (22.8%), "wounds and cuts" (16.8%), "back pain" (10.5%), "strains" (9.4%) and "fractures" (4.5%). A statistically significant association was found between being "a man" and "back pain"; and "a woman" and "sprains". CONCLUSIONS: The predominant pathologies among workplace accidents are of a less serious nature. Some pathologies owing to workplace accidents are mistakenly referred to the health services as ordinary illness. There is insufficient compliance by health professionals with filling in the forms for time off work and return to work.

Absenteeism↗
PubMed1986

[Spontaneous cerebral hematomas. Treatment and follow-up studies].

How to manage spontaneous intracerebral hemorrhage has been in the past years a subject open to discussion. The therapeutic approach, medical or surgical, has constituted a question of debate for the neurosurgeon. The most recent experience, however, attempts to establish the clinical and neuroradiological criteria for medical treatment and clarify the indications, as well as the limitations of surgical treatment. The Authors present 84 cases of spontaneous intracerebral hemorrhage studied by both CT scan and cerebral angiography (October 1980-April 1985). The acute mortality of intracerebral hemorrhage was 17.8%. Determinant for the immediate prognosis was the level of consciousness and the volume of the hematoma. At follow-up, at a median of 3 years after intracerebral hemorrhage, total mortality was 30.9% and 48% had returned work.

Adult↗
PubMed1995

[Surveillance and rehabilitation of cancers of upper respiratory and digestive tracts].

Follow-up of head and neck cancers after treatment is usually done by specialists every 2 to 3 month during an indeterminate period. The aim of this follow up is to detect a recurrence or a complication due to the treatment. Xerostomia, endolaryngeal and cutaneous modifications are the most frequent sequelae of irradiation. Major surgery of the larynx require a speech rehabilitation which gives correct results in 70% of the cases. Professional rehabilitation is possible for few patients: only 50% of the patients who had jobs before treatment were able to go back to work. The return to work was more often seen among civil servants, and workers than among craftsmen. Laryngectomised people resume their work less often than other head and neck cancer patients. There is no problem with social rehabilitation.

Disability Evaluation↗
PubMed1995

[A comparative study of metacarpal resection and translocation after amputation of the middle finger].

The authors studied 43 patients having sustained an amputation of one middle finger treated either by simple ray resection or translocation. The index-middle translocation was followed by more minor postoperative complications compared to all other techniques. A global score, taking into account daily activities, cosmetic result lack of mobility, residual pain, decreased strength, time off work, and return to work gave 131 points for simple third ray resection compare to index middle translocation (-252 points). Surprisingly, reduction of hand span on X ray study was minimal but strength was not correlated and translocation gave better strength, and therefore appears to be more appropriate for manual workers. For ring amputation, the score was definitely better for Leviet translocation with intracarpal osteotomy (143 points versus -36 for simple ray resection). However, the only drawback is more frequent (but minor) residual pain.

Activities of Daily Living↗
PubMed1997

The Americans With Disabilities Act and dermatologists.

The passage and implementation of the Americans With Disabilities Act of 1990 (ADA) has established certain rights in law for persons with disabilities, including patients with skin disease. For workers in workplaces employing more than 15 workers, management may not exclude a worker from a job unless it can be objectively demonstrated that their skin disease will make it impossible for them to perform the essential functions of the job. Employers, at their expense, are now required to provide those disabled with skin disease with reasonable accommodation to allow them to perform their jobs while having their skin impairment. Unless the skin impairment can be shown to place the worker or their fellow workers at material risk to their health, the employer may not exclude them from working--even if the employer is concerned that it may make their skin disease worse. The act applies both to new employees and those acquiring disabling skin disease who are employed and wish to stay at work or return to work. Arbitration of dispute between employees and management are the responsibility of the Equal Employment Opportunities Commission (EEOC), a federal agency responsible for the legislation.

Dermatology↗
PubMedDate not supplied

Immediate return to unrestricted work after inguinal herniorrhaphy. Personal experiences with 27,267 cases, local anesthesia, and mesh.

Complete safety of the patient and unblemished success without recurrence or complication may be assured after inguinal herniorrhaphy as an out-patient if uncompromising intimate attention is paid to the surgical technique in which local anesthesia, polyvinyl ester mesh, and rectus abdominis tendon transfer are used instead of coaptive techniques, and if the post-operative regimen of immediate post-operative ambulation and unrestricted activity is employed. Return to work requiring heavy lifting the same day reduces tension on the mesh, increases the strength of the incision, prevents complications and minimizes pain. The surgical procedure and the virtues of the regimen, which has been eminently successful in 27,267 personal cases, with mesh employed in 18,214 patients, are described.

Activities of Daily Living↗
PubMed1984

[Socioeconomic benefits of coronary dilatation].

The socioeconomic benefits of coronary artery dilatation to the individual and the society in general, were assessed in a review of our first 158 cases in which we studied the length of in-patient treatment, the period off work and the number of patients returning to work after six months and one year. The population included 114 men and 44 women with an average age of 50 +/- 10 years, a history of anginal pain of 18.10 +/- 26.13 months, and of resistant angina of 4.33 +/- 5.72 months. Only one artery was diseased in 130 patients (82%), the remaining patients having multivessel disease. Left ventricular function was normal in 76% of the patients under study. Fifteen patients had already finished working at the time of dilatation and were excluded from the study. One hundred and nineteen (84%) of the 142 patients followed-up were still working before dilatation and 112 (79%) returned to work after 6 months. Of the 94 patients with a good initial result of dilatation, 76 returned to work (81%); 12 initial failures were treated medically, and 6 (50%) returned to work (p less than 0.05); 36 initial failures underwent aorto-coronary bypass surgery and 30.83% are back at work. At one year, 89% of the 103 patients followed-up were working, whilst only 83% of this subgroup were working before dilatation. The 91% of the 69 initial successes have returned to work; 71% of the 7 failures treated medically and 95% of the 27 failures who then underwent bypass surgery, have also returned to work.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Employment patterns and timing of birth in women with high-risk pregnancies.

OBJECTIVE: To describe the characteristics of employed women with high-risk pregnancies, their pattern of employment prenatally and postpartum, and the relationship of prenatal employment to preterm or full-term birth. DESIGN: Secondary analysis with a sample of 171 women with high-risk pregnancies. SETTING: Women's homes and a tertiary care hospital. PARTICIPANTS: Women who were primarily single, African American, and poor; 33% worked or attended school during their pregnancies. MAIN OUTCOME MEASURES: Gestational age at birth, employment, and school attendance. RESULTS: Preterm delivery was not related to when the women stopped working or attending school or were prescribed bed rest. Women employed prenatally were older, had higher incomes, and were more likely to be white or of ethnicity other than African American. Fifty-seven percent of women with a history of prenatal employment and 85% of the women who intended to work after delivery returned to work during the first postpartum year. CONCLUSIONS: Women employed during high-risk pregnancies are similar demographically to women with low-risk pregnancies in other studies. Most of the women stopped working or attending school because of prescribed bed rest. Bed rest, however, was not related to preterm delivery. Most women who planned to return to work did so. Factors other than the women's high-risk pregnancies, such as attitudes toward employment, employability, and family circumstances, most likely influenced their employment status. Current welfare reform initiatives will increase the number of women working while pregnant. This article provides pre-welfare-reform baseline data concerning patterns and effects of employment for women with high-risk pregnancies. These data will enable nurses to examine the effects of welfare reform on employment during pregnancy and preterm birth.

Adolescent↗
PubMed1994

Extent of disability following traumatic extremity amputation.

Extremity amputation is a devastating injury. Forty-two patients who sustained traumatic limb amputation were contacted 3-57 months (mean, 25 months; median, 24 months) after injury to evaluate residual disability and to determine what factors were associated with a good recovery. There were 35 men and 7 women with ages ranging from 5 to 73 years (mean, 34 years). Amputation was the result of a motor vehicle crash in 18, work-related injury in 11, motorcycle crash in 9, and other causes in 4. There were 46 amputations done: 8 above-knee (AK), 25 below-knee (BK), 5 above-elbow (AE), and 9 below-elbow (BE). Twenty patients reported no problems with their prosthesis, 8 had major (e.g., infections) and 6 had minor (e.g., skin breakdown) problems. Eight patients did not receive or did not use a prosthesis. Fourteen patients were discharged to an inpatient rehabilitation facility, 25 to home with outpatient rehabilitation, and 3 had no rehabilitation. Of those who worked before their injury, only 50% returned to work. The mean and median time to return to work were 14 and 12 months, respectively. Three of five full-time students returned to school. The amputation level in patients returning to work or school was BK in 12, BE in 3, and AE in 1. No patient with a AK amputation and only 1 (9%) patient with a work-related injury returned to work. Associated injuries or inpatient rehabilitation did not correlate with returning to work. Eighty-eight percent of patients were satisfied with their adjustment and could perform all activities of daily living.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2006

Duration dependence in sickness absence: how can we optimize disability management intervention strategies?

OBJECTIVE: The optimal timing of interventions during sickness absence remains difficult to determine, because we do not have a clear picture of the presence and type of duration dependence that exists. This study investigates the impact of an intervention by the occupational physician as well as of socioeconomic and work-related factors on duration dependence during sickness absence. METHODS: Analyses were performed at the population level using data from a major longitudinal survey on work incapacity and return to work in The Netherlands. Several models of duration dependence are estimated. RESULTS: Evidence is found for the presence of variable-duration dependence. Characteristics that influence duration dependence of the return-to-work (RTW) rate are identified. CONCLUSIONS: The findings imply that RTW intervention strategies should vary according to differences in workers' susceptibility to positive or negative duration-dependence effects.

Absenteeism↗
PubMed1993

Recovery following orthognathic surgery: mandibular bilateral sagittal split osteotomy and Le Fort I osteotomy.

Thirty-eight patients, who underwent orthognathic surgery, reported their recovery period upon returning to work or school and returning to full activity. Twenty-six patients had isolated bilateral sagittal split osteotomies (BSSO) and 12 had isolated Le Fort I osteotomies (LFI). At 1 to 2 weeks postoperatively, 50% of the BSSO group had returned to work or school while none of the LFI group had returned. By 3 to 4 weeks, 81% of the BSSO group had returned to work or school while nearly one half of the LFI group still had not returned. The BSSO group returned to full activity earlier than the LFI group, although the differences were not statistically significant. Hemoglobin, hematocrit, weight, and vital signs were determined preoperatively and for 6 weeks postoperatively. The LFI group had a larger mean estimated blood loss, length of operation, and weight loss.

Absenteeism↗
PubMed1998

Approaches to improve the outcome of patients with delayed recovery.

The purpose of this chapter is to promote a model to prevent chronicity and disability from non-specific low back pain (NSLBP). Delayed recovery is defined in this chapter as the period between 4 and 8 weeks after onset of NSLBP during which a patient has not yet returned to work. The recognition of predictors associated with delayed recovery at onset of the problem helps health care providers in their treatment plan. An algorithm can be useful for health care providers and employers in guiding the employee back to work. A multidisciplinary return to work programme is an essential part of the algorithm.

Chronic Disease↗
PubMed1988

Quality of life following cerebral bypass surgery.

Information available for nurses on counseling cerebral bypass patients regarding the outcomes of surgery is limited. In order to assess the impact of surgery on the patient's quality of life, a questionnaire was mailed to a sample of cerebral bypass patients who were at least three months postoperative and had suffered an ischemic event prior to surgery. Objective and subjective indicators were used to assess quality of life. Objective measures included type and frequency of symptoms most often associated with ischemic events, as well as return to work status. Subjective aspects included an overall assessment of life satisfaction as measured by the Cantril Self Anchoring Scale and satisfaction with these related domains of life: family, social, sex and occupation. Perceptions of body image were also examined. One hundred and two questionnaires were analyzed. Results indicated that for patients who were working before surgery, return to work was significant (p less than .0001). The signs and symptoms most often associated with an ischemic event were identified and overall, the number of reported symptoms was significantly decreased (p less than .0001) after surgery. In addition, an analysis of variance (ANOVA) with repeated measures indicated that patients viewed present and future life as better than life prior to surgery. Patients also reported greater satisfaction with family life (p less than .0001) and body image (p less than .01) following surgery. This information will be useful to nurses in diagnosing and counseling patients with stroke symptoms as well as in developing a comprehensive plan of care for patients who may undergo cerebral bypass surgery.

Activities of Daily Living↗
PubMed2005

Functional outcome and health-related quality of life after surgical repair of full-thickness rotator cuff tear using a mini-open technique.

BACKGROUND: Rotator cuff tear, a common shoulder injury, can lead to shoulder pain and functional loss. HYPOTHESIS: Surgical repair of full-thickness rotator cuff tears using the mini-open surgical technique will improve shoulder function and health-related quality of life. STUDY DESIGN: Cohort study. Level of evidence, 2. METHODS: Patients with a full-thickness rotator cuff tear who underwent a mini-open repair were evaluated for (1) active shoulder range of motion preoperatively, and 6 months and 12 months postoperatively and (2) health-related quality of life preoperatively, 6 months postoperatively, and annually up to 5 years postoperatively. Satisfaction with the repair and return to work status were ascertained 1 year postoperatively. A subgroup analysis of tear size and patient age was also undertaken. RESULTS: Of the subjects, 61 (73%) were men, and the average age was 53.2 ( +/- 9.9) years. According to repeated-measures analysis of variance, shoulder range of motion (flexion and external rotation) improved significantly from before surgery to 1 year after surgery (P <.001). The mean American Shoulder and Elbow Surgeons scores improved from 53.3 ( +/- 20.6) preoperatively to 90.6 ( +/- 11.7) 1 year postoperatively (P <.001). The mean Western Ontario Rotator Cuff scores also improved from 43.2 ( +/- 20.2) preoperatively to 87.2 ( +/- 14.3) 1 year postoperatively (P <.001). No differences were seen in either the American Shoulder and Elbow Surgeons scores or Western Ontario Rotator Cuff scores between the 1-year examination and the last follow-up assessment undertaken at a median of 5 years postoperatively (P >.05). Ninety-six percent of patients were satisfied or very satisfied with the results of their repair; 78% of patients who were working before surgery returned to work without modification by 1 year postoperatively. For the most part, patient age and size of tear did not influence postoperative range of motion or health-related quality of life. CONCLUSION: Mini-open rotator cuff repair led to improved shoulder function and health-related quality of life up to 5 years postoperatively.

Adult↗
PubMed1991

The probability of return migration, migrants' work effort, and migrants' performance.

"This paper demonstrates that differences in earnings between migrants and the native population may reflect differences in incentives rather than differences in characteristics. The analysis indicates that in the presence of a positive probability of return migration, migrants' work effort is higher than that of comparable native-born workers. This differential may explain why, even if all workers are perfectly homogeneous in skills, migrants often outperform the native-born workers in the receiving economy."

Behavior↗