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[The "Freiburg Spinal Study"--epidemiology of occupationally-induced spinal diseases of health care employees in Germany].

Musculoskeletal diseases are very common in modern societies. As several international investigations have shown that the etiology of these diseases is correlated with working conditions in some professions. With financial subsidy by the German insurance company for the regulation and compensation of occupational diseases in the health care sector (BGW), we investigated in 6 different projects the possible relation of working conditions and musculoskeletal diseases among health care professionals, esp. nurses. Our contribution describes the design of the different sub-projects and presents some results. The summarising discussion points out that there was a strong tendency in all sub-projects to confirm the hypothesis that nurses run a significantly higher risk to suffer from work-related musculoskeletal diseases and disorders. The results of the sub-project "cohort study in nursing pupils" support this hypothesis. The results do not only supply important background information for the process of compensating occupational diseases in this field but also indicate a tremendous personal and structural need for more and better prevention.

Adult↗
PubMed1991

Reflex anal dilatation: effect of parting the buttocks on anal function in normal subjects and patients with anorectal and spinal disease.

Anal dilatation in response to gentle parting of the buttocks has been advocated as a sign of sexual abuse in children, but nothing is known of the physiology of this response or its existence in normal subjects, in patients with spinal disease, and in patients with a weak sphincter and whether it can be elicited after training. To answer these questions we investigated the effect of parting the buttocks on anal function. Combined anal manometry and electromyography was conducted in six normal subjects (five men, one woman, aged 19-53 years), in 18 patients with faecal incontinence (three men, 15 women, aged 30-80 years), and in seven paraplegic patients (six men, one woman, aged 25-36 years), in four of whom the posterior sacral roots had been cut. Parting the buttocks in normal subjects reduced the pressure in the anal canal from 102 (20) to 14 (3) cm H2O (mean (SEM), p less than 0.00001), but did not cause the anus to gape. This drop in pressure was associated with increased electrical activity in the external anal sphincter. Normal subjects could consciously relax the external anal sphincter and reduce the anal pressure but not so as to result in anal gaping during traction on the buttocks, even after anal dilatation. Stimulation of the anal lining by moving a probe in and out of the anal canal increased the activity of the external anal sphincter, raising anal pressures. Paraplegic patients who had lost conscious control of their external sphincters showed anal gaping when the buttocks were parted. A similar phenomenon was seen in patients with faecal incontinence who had weakness of the external anal sphincter, while incontinent patients with weakness of both sphincters showed anal gaping even at rest. Inasmuch as the results of our study can be applied to children, the data suggest that reflex anal dilatation should only be used to support a diagnosis of sexual abuse if sphincter function is otherwise normal and there is no evidence of cerebrospinal disease. Although our results do not support the notion that children could become so conditioned to repeated digital or penile penetration of the anus that they can cause the anus to gape when the buttocks are parted, neither do they exclude it.

Adult↗
PubMed2004

Dietary support with Boswellia resin in canine inflammatory joint and spinal disease.

An open multi-centre veterinary clinical trial, comparing conditions before and after treatment with a herbal dietary supplement consisting of a natural resin extract of Boswellia serrata, was conducted by 10 practicing veterinarians in Switzerland. This traditional plant-based supplement is known for its anti-rheumatic and anti-inflammatory properties. 29 dogs with manifestations of chronic joint and spinal disease were enrolled. Osteoarthritis and degenerative conditions were confirmed radiologically in 25 of 29 cases. The resin extract (BSB108, product of Bogar AG) was administered with the regular food at a dose of 400 mg/10 kg body weight once daily for 6 weeks. Already after two weeks of treatment, an overall efficacy of the dietary supplement was evident in 71% of 24 eligible dogs. A statistically significant reduction of severity and resolution of typical clinical signs in individual animals, such as intermittent lameness, local pain and stiff gait, were reported after 6 weeks. Effects of external factors that aggravate lameness, such as "lameness when moving" and "lameness after a long rest" diminished gradually. In 5 dogs, reversible brief episodes of diarrhea and flatulence occurred, but only once was a relationship to the study preparation suspected. Because quality and stability of the resin extract were ensured, these data suggest that a standardized preparation can be recommended as a herbal dietary supplement providing symptomatic support in canine osteoarthritic disease.

Animals↗
PubMed1989

[The pathology of spinal diseases].

In painful lesions of the spine, the diagnosis must be established by different radiological methods and, in addition, confirmed histologically by a biopsy. For this purpose, representative tissue samples can be obtained by needle biopsy. The cause of backache may be degenerative processes, systemic osteopathies, traumatic lesions, bone necroses, bone granulomas, metabolic disorders, inflammation, pathologic bone remodelling, or bone tumors. Using autopsy material, even macroscopic analysis is possible. Pathological-anatomical, and radiological findings are essential for the diagnosis and therapy of most lesions of the spine.

Biopsy, Needle↗