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PubMed2003

Changes in working conditions and health among dairy farmers in southern Sweden. A 14-year follow-up.

The objective of this study was to describe and analyse the changes in working conditions and health among dairy farmers in Scania in southern Sweden during the period 1988-2002 by a repeat of a mail-in survey. Altogether, 83 % of the male and 90 % of the female dairy farmers reported some kind of symptoms in the musculoskeletal system during the 12 months prior to the 2002 questionnaire. This is an increase compared to the farmers in 1988. The highest significant changes were an increase of symptoms in the shoulder, neck and in the wrists/hands. The milkers reported most often incidental as well as persistent symptoms in the shoulders. The frequency of hip symptoms was significantly higher among those male milkers who had quit milking during the interim than for the active milkers in 1988. The milkers studied in 2002 had, on average, increased their working time per week, increased the number of cows milked as well as the use of more milking units. In 1988, almost all the milkers studied were working in tethering systems while in 2002 more than one quarter were working in loose-housing systems. The opinion among most of the farmers, both in 1988 and in 2002, regardless of age or sex, was that silage handling and the milking procedure were the most strenuous work operations. On the other hand, the milkers obtained their greatest pleasure from the actual milking job as well as from their work to promote the welfare of the animals. Unprofitability and great investment demands had a bearing on the retirement of milkers but, on the other hand, a high potential of the milkers could have continued 10-15 more years as dairy farmers if the work conditions had been better, e.g. associated with fewer health problems. Apart from the need for developing technical devices to facilitate the milking operation, further research is needed concerning the dairy farmers' well-being and quality of life, perceived stress, and leisure time activities and how these and similar factors influence the prevalence of musculoskeletal symptoms. Strategies for preventive and intervention measures must consider physical workplace factors as well as personal and lifestyle characteristics.

Agricultural Workers' Diseases↗
PubMed1993

Changes in markers of bone formation and resorption in a bed rest model of weightlessness.

To study the mechanism of bone loss in physical unloading, we examined indices of bone formation and bone resorption in the serum and urine of eight healthy men during a 7 day -6 degrees head-down tilt bed rest. Prompt increases in markers of resorption--pyridinoline (PD), deoxypyridinoline (DPD), and hydroxyproline (Hyp)/g creatinine--during the first few days of inactivity were paralleled by tartrate-resistant acid phosphatase (TRAP) with significant increases in all these markers by day 4 of bed rest. An index of formation, skeletal alkaline phosphatase (SALP), did not change during bed rest and showed a moderate 15% increase 1 week after reambulation. In contrast to SALP, serum osteocalcin (OC) began increasing the day preceding the increase in Hyp, remained elevated for the duration of the bed rest, and returned to pre-bed rest values within 5 days of reambulation. Similarly, DPD increased significantly at the onset of bed rest, remained elevated for the duration of bed rest, and returned to pre-bed rest levels upon reambulation. On the other hand, the other three indices of resorption, Hyp, PD, and TRAP, remained elevated for 2 weeks after reambulation. The most sensitive indices of the levels of physical activity proved to be the noncollagenous protein, OC, and the collagen crosslinker, DPD. The bed rest values of both these markers were significantly elevated compared to both the pre-bed rest values and the post-bed rest values. The sequence of changes in the circulating markers of bone metabolism indicated that increases in serum OC are the earliest responses of bone to head-down tilt bed rest.

Acid Phosphatase↗
PubMed1995

Streptozotocin-induced diabetes decreases substance P levels in experimental arthritis in the rat knee.

Diabetic patients with sensory neuropathy are predisposed to disorders of the musculoskeletal system. It has been postulated that altered neurogenic inflammation, involving the neuropeptide substance P, may play a part in this phenomenon. We investigated the effect of streptozotocin-induced (STZ) diabetes on the development of an antigenic (mBSA) monoarthritis in the rat with particular reference to changes in substance P levels in dorsal root ganglia (DRG) and knee joint synovium. We found that STZ-induced diabetes of 24 weeks duration reduced the substance P content of L4/L5 DRG and knee joint synovial tissue. Induction of mBSA arthritis in diabetic rats resulted in diminished increases in synovial substance P and knee joint swelling compared to non-diabetic arthritic controls. The results show that chronic STZ diabetes reduces neurogenic inflammatory responses in the rat knee which may render the joint more susceptible to arthritic attack.

Animals↗
PubMed2005

Design and evaluation approach for increasing stability and performance of touch pens in screen handwriting tasks.

Touch pens allow user to write directly on a computer screen. An ergonomically designed touch pen can improve user performance and reduce musculoskeletal injuries. This study investigates the touch pen use in three sections. First, observations of users' handwriting during three screen tasks: writing, pointing-and-clicking and drawing. Second, examinations of the design and development of touch pens based on observed results and related design theory. Third, this study compares the five-point grip pen (FPGP) with the common touch pen. Study conclusions are as follows: (1) The gesture of gripping a common touch pen for on-screen handwriting is unnatural; that is, users tend to use the wrist, elbow or little finger for support. A user's hand and fingers are in a more natural position when using an FPGP. (2) User performance with the FPGP is superior to that with the common touch pen during three screen tasks. (3) The advantages of the FPGP include: increased hand stability, reduced hand fatigue, enhanced performance, and provided adjustability. (4) This study proposed an FPGP whereby a brace was added to a touch pen to increase the stability during screen-based tasks. The idea of adding a brace can be applied to those tasks requiring higher accuracy or continuous freehand without other limb support tasks, such as wall-painting, surgery operation, and other aiming tasks.

Adult↗
PubMed2006

Spatio-temporal expression of Pbx3 during mouse organogenesis.

Pbx3 is a member of the Pbx family of TALE (three amino acid loop extension) class homeodomain transcription factors. These transcription factors are implicated in developmental and transcriptional gene regulation in numerous cell types through their abilities to form hetero-oligomeric DNA-binding complexes. Pbx3 was found to be expressed at high levels in the developing central nervous system (CNS), including a region of the medulla oblongata which is implicated in the control of respiration. Furthermore, as reported, Pbx3-deficient mice develop to term but die within a few hours of birth from central respiratory failure. In this study, we have characterized Pbx3 expression patterns during organogenesis in numerous tissues and organ systems other than the CNS, as a first step toward understanding the potentially overlapping functions of Pbx3 with other Pbx family members during vertebrate development. We have performed in situ hybridization on whole mount and sectioned mouse embryos from gestational day (E) 9 to E16.5. During early organogenesis, until E12.5, Pbx3 expression is found mostly in the embryonic head, forelimbs, and septum transversum, unlike Pbx1 and Pbx2 expression which is more widespread. Conversely, later in organogenesis, Pbx3 expression becomes more widely detectable throughout the developing embryo. Epithelial and mesenchymal tissues, as well as the CNS, represent major sites of Pbx3 expression. The enteric nervous system also expresses high levels of Pbx3, distinctively in the cells of the ganglia of Auerbach's myenteric nerve plexus, that also express Dlx2 and Notch1. Cartilage is also a site of Pbx3 expression. Interestingly, like Pbx1, Pbx3 is highly expressed in proliferating chondrocytes but is lost as chondrocytes become hypertrophic during endochondral ossification. Finally, Pbx3 is expressed only in the forelimb buds during early limb development, while the hindlimb bud is devoid of Pbx3. This finding leads us to add Pbx3 to the sparse list of early forelimb-specific molecular markers.

Animals↗
PubMed1995

Musculoskeletal manifestations of Lyme disease.

Musculoskeletal involvement, particularly arthritis, is a common feature of Lyme disease. Early in the illness, patients may experience migratory musculoskeletal pain in joints, bursae, tendons, muscle, or bone in one or a few locations at a time, frequently lasting only hours or days in a given location. Weeks to months later, after the development of a marked cellular and humoral immune response to the spirochete, untreated patients often have intermittent or chronic monoarticular or oligoarticular arthritis-primarily in large joints, especially the knee-during a period of several years. The diagnosis of Lyme arthritis is usually based on the presence of this characteristic clinical picture, exposure in an endemic area, and an elevated immunoglobulin G antibody response to Borrelia burgdorferi. In addition, spirochetal DNA can often be detected in joint fluid by polymerase chain reaction. Lyme arthritis can usually be treated successfully with 1-month courses of oral doxycycline or amoxicillin or with 2- to 4-week courses of intravenous ceftriaxone. However, patients with certain genetic and immune markers may have persistent arthritis, despite treatment with oral or intravenous antibiotics. B. burgdorferi may occasionally trigger fibromyalgia, a chronic pain syndrome with diffuse joint and muscle symptoms. This syndrome does not appear to respond to antibiotic therapy.

Arthritis, Infectious↗
PubMed2001

Towards successful physical stress reducing products: an evaluation of seven cases.

Lifting, carrying, pushing and pulling at work are assumed to be related to increased risks of musculoskeletal injury, mainly in the low back and shoulder region. The implementation of products to reduce the physical load in heavy work is a well-known strategy to attack this problem. The success of these products depends not only on the product itself, but also on the process of product development and implementation. In this paper, seven cases are described where products have been developed to reduce the physical load on scaffolders, bricklayers, bricklayer's assistants, roofworkers, aircraft loaders, glaziers and assembly line workers. These products are described with special reference to the physical load problem in the occupational task, the process of product development, the nature of the product, the potential effects on physical load and the opinion of workers. From these cases, a list of key factors in product development contributing to the success of a product is composed. These concern among others a direct participation of workers, a wide analysis of risks, an analysis of potential negative side effects, and a systematic stepwise approach.

Equipment Design↗
PubMed1987

Surveillance for skeletal toxicity of children treated with etretinate.

Following recent reports of the development of skeletal abnormalities in patients treated with etretinate (Tigason), we have examined 19 children and adolescents on long-term treatment with etretinate, using 99mtechnetium methylene diphosphonate (99mTcMDP) whole body bone scans and musculoskeletal assessment. No significant bony abnormalities were detected. We believe that the available evidence does not warrant alarm, and that long-term etretinate therapy can probably be given with a low risk of musculoskeletal toxicity if certain precautions are taken, in particular the use of low maintenance dose levels, early investigation of symptoms of musculoskeletal pain or stiffness, and regular 99mTcMDP bone scans.

Adolescent↗
PubMed2006

Anesthesia in a child with fibrodysplasia ossificans progressiva.

We describe the anesthesia management of a 12-year-old girl, diagnosed with fibrodysplasia ossificans progressiva (FOP), who presented with a submandibular abscess. FOP is a rare, inherited disorder with heterotopic bone formation and progressive musculoskeletal disability. This disability ultimately confines patients to a wheelchair. Minor trauma following dental treatment may lead to ankylosis of the jaw. Subsequent to this disability, which resulted in poor dental hygiene, our patient developed a dental abscess. This spread along the mandibular margin and under the tongue. She presented with an impending airway compromise in an already difficult situation. The options for airway management in a child with limited mouth opening are discussed.

Ambulatory Surgical Procedures↗
PubMed2004

Ergonomic pain--part 1: etiology, epidemiology, and prevention.

Work-related musculoskeletal disorders (MSDs) have reached a costly epidemic proportion in recent years, producing ergonomic pain as their most frequent clinical consequence. While work-related MSDs have declined in incidence, their prevalence continues. Individuals develop symptoms as a consequence of numerous factors that include force, sustained posture, repetitive motion, and vibration. Different combinations of these factors lend to different pathomechanical and pathophysiological consequences that appear to be unique to different regions of the body and related to distinctive work environmental and task characteristics. Federal and state agencies have made considerable attempts to regulate the work environment in a preventative fashion in order to reduce the incidence of ergonomic pain and other sequelae of work-related MSDs.

Journal Article↗
PubMed2005

Science of assessment.

Psoriatic arthritis is a multisystem disorder which, from a measurement standpoint, demands consideration of its cutaneous manifestations and both axial and peripheral musculoskeletal involvement. Measurements of various aspects of impairment, ability/disability, and participation/handicap are feasible using existing measurement techniques, which are for the most part valid, reliable, and responsive. Nevertheless, there remain opportunities for the further development of consensus around core set measures and responder criteria, as well as for instrument development and refinement, standardised assessor training, cross-cultural adaptation of health status questionnaires, electronic data capture, and the introduction of standardised quantitative measurement into routine clinical care.

Arthritis, Psoriatic↗
PubMed1987

Fragility and composition of growing rat bone after one week in spaceflight.

To gain some insight into the early effects of spaceflight on skeletal metabolism, we quantified the major chemical constituents and a noncollagenous protein, osteocalcin, in the third-lumbar vertebrae and humeri from 8-wk-old rats that were part of the 7-day NASA Spacelab 3 flight experiments. The ratio of calcium to hydroxyproline in the humeral diaphysis increased from 8.5 in preflight to 9.8 in ground simulation control and only to 8.9 in flight bones. There was no demonstrable change in the fraction of nonmineralized collagen. Osteocalcin content was reduced in the humerus and vertebra. Reduced accumulation of mineral and osteocalcin with no associated decrease in collagen in flight animals suggests that both mineralization and collagen metabolism are impaired in growing animals during spaceflight within a few days after launch. Strength tests of the humeri of flight rats showed substantial deficits that appeared to be related, not only to the reduced bone mass, but also to the composition and quality of new bone formed.

Animals↗
PubMed1998

Bioabsorbable polymers: materials technology and surgical applications.

Biostable and bioabsorbable biomaterials are used to manufacture implants for supporting, replacement, augmentation and guiding of growth of tissues. Bioabsorbable implants are a better choice for applications where only the temporary presence of the implant is needed. Because of bioabsorption of such implants, there is no need for a removal operation after healing of the tissue and the risks of implant related, long-term complications are eliminated or strongly reduced. Reinforcing of bioabsorbable materials is necessary in order to develop strong and safe, small implants for fixation of bone fractures and connective tissue damage. Self-reinforced bioabsorbable polymeric implants have been used so far extensively in the treatment of traumas of the musculoskeletal system.

Biocompatible Materials↗
PubMed2003

Progress and controversy surrounding vaccines against Lyme disease.

Less than 20 years elapsed between the 1982 report of the identification and isolation of Borrelia burgdorferi and the licensure and marketing in the USA of a prophylactic vaccine against this pathogen. However, the manufacturer removed the vaccine from the market under 4 years after its release. The low demand undoubtedly was the result of limited efficacy, need for frequent boosters, the high price of the vaccine, exclusion of children, fear of vaccine-induced musculoskeletal symptoms and litigation surrounding the vaccine. Second-generation polyvalent outer surface protein (Osp)C vaccines may overcome some of these concerns but the precise antigenic components required for efficacy are uncertain. The development of the next generation of Lyme disease vaccines is in its infancy.

Animals↗
PubMed1992

The potential impact of epidemiology on the prevention of occupational disease.

This presentation reviews occupational epidemiology as a foundation for workplace disease prevention activities. By examining descriptive, etiologic and intervention occupational epidemiology studies, a range of opportunities are illustrated where epidemiology has played, or could play a principal role in guiding preventive efforts. Descriptive studies presented include ones based on vital records, on epidemic investigations, cross-sectional surveys, and surveillance. Etiologic studies review the largely successful development of knowledge for lung cancer and asbestos exposure for pulmonary effects of isocyanate exposures. However, attention is also directed to the need for etiologic studies of work environment risks for both cardiovascular and musculoskeletal disease. Finally importance is placed on the too infrequent epidemiologic studies of intervention. Historical examples of control of large risks from nickel cancers and silicosis are balanced with more recent examples of successes at reducing smaller risks of cardiovascular disease and oil acne. Throughout, emphasis is placed on the importance of reintegrating the academic discipline of epidemiology into the application of study findings to prevention of workplace risks.

Causality↗
PubMed1984

Early skeletal hyperostoses secondary to 13-cis-retinoic acid.

Prolonged therapy with retinoid drugs (chemically similar to vitamin A) often results in skeletal hyperostoses, similar to those seen in idiopathic skeletal hyperostosis. Eight patients, aged 5-26 years, with dermatologic disorders were treated with 13-cis-retinoic acid. Skeletal surveys were obtained before and during treatment. In 1 year, six of the eight patients had developed such skeletal hyperostoses in both axial and appendicular regions. The cervical spine was the most common site of involvement. None of the children demonstrated accelerated skeletal maturation. Two of the patients had mild musculoskeletal discomfort during this period. The findings indicate that high-dose 13-cis-retinoic acid therapy may cause skeletal hyperostoses, requiring radiographic monitoring during prolonged periods of treatment. An implication of these observations, relating to the etiology of idiopathic skeletal hyperostosis, is discussed.

Adolescent↗
PubMed2003

On the modelling bone tissue fracture and healing of the bone tissue.

This paper reviews the available literature on computational modelling in two areas of bone biomechanics: fracture and healing. Bone fracture analysis attempts to predict the failure of musculoskeletal structures by several possible mechanisms under different loading conditions. However, as opposed to structurally inert materials, bone is a living tissue that can repair itself. An exciting new field of research is being developed to better comprehended these mechanisms and the mechanical behaviour of bone tissue. One of the main goals of this work is to demonstrate, after a review of computational models, the main similarities and differences between normal engineering materials and bone tissue from a structural point of view. We also underline the importance of computational simulations in biomechanics due to the difficulty of obtaining experimental or clinical results.

Biomechanical Phenomena↗
PubMedDate not supplied

Assessment of pain in rheumatic diseases.

Pain is the most prominent symptom in people with musculoskeletal disorders, and the most common motivation for patients seeking medical help. However, pain generally is not recorded quantitatively in routine medical care. Over the last three decades, self-report questionnaires have been developed in which a patient may record quantitatively a pain score at baseline and over time to determine whether their condition has improved, remains unchanged, or has worsened. The most robust quantitative pain measure appears to be a simple 10 cm visual analog scale (VAS), which can be completed by the patient and scored by a health professional in less than 10 seconds. Quantitative data concerning pain cannot be obtained from any source other than the patient. Quantitative assessment of pain at each visit in routine rheumatology care, along with the assessment of functional disability, global status, and other patient variables, using a patient self-report questionnaire might lead to improved patient care.

Humans↗