One dimension of Upper-Limb Work-related MusculoskeletalDisorders (UWMSD) prevention is implementation of surveillance systems. Some authors have proposed a multi-level model for surveillance of UWMSD and their risk factors, such as a first level using questionnaires and checklists, for a rapid assessment, and a second level including clinical examinations and in- depth job analysis by trained health care providers (Scientific committee for musculoskeletaldisorders of the ICOH 1996; Hagberg et al. 1995; Ricci et al. 1998). However, very few evaluations of these surveillance system have been performed (Hagberg et al. 1995; Silverstein et al. 1997; Burdorf et al. 1997).
The occupational physicians were trained by the study investigators to perform a standardized physical examination, based on an international protocol for the evaluation of work-related upper-limb musculoskeletaldisorders (Saltsa) ( 25 ). The training was similar to that of the Repetitive task survey. They began the examination by asking the worker about upper-limb pain in the preceding 12 months. “ ” Participants with pain in the shoulder/arm, elbow, hand/wrist, or fingers underwent a standardized localized clinical examination. The physical examination allowed the detection of six disorders: rotator cuff syndrome, lateral epicondylitis, ulnar nerve entrapment at the elbow (cubital tunnel syndrome), extensor/flexor tendonitis/tenosynovitis, de Quervain s disease and carpal tunnel syndrome. The physical ’ examination was considered as positive if any of the 6 principal upper limb disorders was present.
Upper-limb work-related musculoskeletaldisorders (UWMSD) are an important problem in industrial countries. There is strong evidence for association between biomechanical exposures and these disorders (Hagberg et al. 1997; Roquelaure et al. 2002; Bernard BP 1997). Various assessment methods of biomechanical exposure are available, especially ergonomic analyses and questionnaires (Stock et al. 2005). Questionnaires are frequently used in surveillance programs since they are considered in many contexts as simple and valid tools for biomechanical exposure assessment (Leclerc 2005; Balogh et al. 2001; Hansson et al. 2001; Chen et al. 2002). For instance, Hagberg et al. had proposed a two level surveillance method for work exposure, with a first level based on questionnaire and check-list.
6. Dougados M. The mesurement: evaluation methods for rhumatisms. [La mesure. Méthodes d'évaluation des affections rhumatismales]. Paris: Expansion scientifique (Elsevier), 1997.
7. Sluiter BJ, Rest KM, Frings-Dresen MH. Criteria document for evaluating the work- relatedness of upper-extremity musculoskeletaldisorders. Scand J Work Environ Health 2001;27 Suppl 1:1-102.
Physicians in primary care play a central role in the man- agement of musculoskeletaldisorders (MSDs). This group of health problems also represents a leading reason of recourse to complementary and alternative medicines (CAM) including homeopathy. There is a paucity of information describing MSD patients using CAMs and almost none distinguishing homeopathy from other forms of CAM. In France, homeopathy is the most fre- quently used CAM and is prescribed only by physicians, typically general practitioners (GP). In addition, homeop- athy is reimbursed by the French National Health Insur- ance which allowed a fair comparison of patients who seek care with physicians who prescribe and don’t pre- scribe homeopathy and CAMs. The objective of this study was to describe and compare patients with MSDs consulting primary care physicians, either certified homeopaths (Ho) or regular prescribers of CAMS in a mixed practice (Mx), to those consulting physicians who practice strictly conventional medicine (CM), with regard to the severity of their MSD expressed as chronicity, co-morbidity and quality of life (QOL).
Charlotte Lanhers 1,2,3* , Bruno Pereira 4 , Chloé Gay 1 , Christian Hérisson 6 , Christine Levyckyj 7 , Arnaud Dupeyron 5 and Emmanuel Coudeyre 1,2,8
Background: Musculoskeletaldisorders (MSDs) constitute a major occupational health problem in the working population, substantially impacting the quality of life of employees. They also cause considerable economic cost to the healthcare system, with, notably, the reimbursement of treatments and compensation for lost income. MSDs manifest as localized pain or functional difficulty in one or more anatomical areas, such as the cervical spine, shoulder, elbow, hand, and wrist. Although prevalence varies depending on the region considered and the method of assessment, a prevalence of 30% is found in different epidemiological studies. The disease needs to be
Title : The Risk Assessment of Work-related MusculoskeletalDisorders based on OpenSim
Keywords : Musculoskeletal model, muscle fatigue, work design, work load, posture, load analysis, OpenSim model
Work-related musculoskeletaldisorders cause physical and mental illnesses in workers, reduce their productivity and cause great losses to industries and society. This thesis focuses on the assessment of the physical risk of work-related musculoskeletaldisorders in industry, for which four key points are identified: measuring workloads, assessing the effect of workload accumulation, quantifying individual characteristics and integrating the risk assessment into digital human modeling tools. In the state of the art, the epidemiologic studies of musculoskeletal disoders and the current methods used for its physical risk assessment are reviewed, as well as the studies concerning the four key points. The second part presents an experimental study involving 17 subjects to explore a new indicator to muscle fatigue with surface EMG. In the next part, efforts are made
Four new, agreed-upon statements concerning preven- tion of musculoskeletaldisorders in workers were extra- polated from the discussions with scientists in the field: 1. Musculoskeletal discomfort that is at risk of worsen- ing with work activities, and that affects work ability or quality of life, needs to be identified. 2. We need to know our options of actions before identifying workers at risk (providing evidence-based medicine and applying the principle of best practice). 3. Classification systems and measures must include aspects such as the severity, frequency, and intensity of pain, as well as measures of impairment of functioning, which can help in preven- tion, treatment and prognosis. 4. We need to be aware of economic and/or socio-cultural consequences of clas- sification systems and measures.
General health effects of our intervention
Overall, the neck, shoulders, and upper and lower back were the most affected regions among our computer users, in line with the literature. 31 Moreover, computer- related visual and ocular symptoms are the most fre- quently occurring health problems in people who spend a large proportion of their working day looking at a computer screen. 37 Given the high prevalence of these symptoms, 38 it is likely that all VDU workers will at some point need eye examinations in order to assess symp- toms associated with VDU use. Furthermore, visual and musculoskeletal discomfort have been intrinsically linked together. 39 To the best of our knowledge, our study was the ﬁrst to simultaneously evaluate and reduce MSDs in combination with ocular symptoms. 40 41
The structural pathology paradigm is guided by the inherent belief that pain and other neurophysiological changes are secondary to local structural insult to musculoskeletal structures. Both in animal and human studies, it is apparent that local and systemic inflammatory responses, cellular and vascular proliferative changes as well as degeneration and fibrosis are all hallmarks of chronic and overuse MSD (Barr et al. 2000; Barbe et al. 2003; Barr et al. 2004; Barr 2006; Barbe and Barr 2006). Injury to musculoskeletal structures, inflammatory mediators, and subsequent fibrosis change the mechanics of muscles and connective tissues affecting their physical properties and these in turn impacting sensory receptor activity and transmission (Petersen-Felix et al. 2002; Wilder-Smith et al. 2002; Barr et al. 2004; Costigan et al. 2009; Phillips et al. 2011; Coombes et al. 2009; Langevin and Sherman 2007). Under the structural- pathology paradigm neurophysiological consequences, with the exception of damage to the nerve(s), are secondary and should disappear when normal tissue properties are restored, and receptor activity, sensory transmission, and perception should renormalize to reflect the state of the healed structure(s). Within this paradigm pain is simply a symptom and reflects the degree of damage to the musculoskeletal structure and associated biological responses locally in the area of injury. This viewpoint is supported by the findings that demonstrates the reversal of some, but not all Central Nervous System (CNS) changes when anatomical insult to musculoskeletal structures and pain disappears (Rodriguez-Raecke et al. 2009; Seminowicz et al. 2011).
Background: Our aim was to examine whether comorbid mood and anxiety disorders influence patterns of treatment or the perceived unmet need for treatment among those not receiving treatment for illegal drug use disorders. Methods: Data came from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, 2001–2002 and 2004–2005, n = 34,653). Lifetime DSM-IV illegal drug use disorder (abuse and dependence), as well as comorbid mood (major depression, dysthymia, manic disorder, hypomanic disorder) and anxiety disorders (panic disorder, agoraphobia, social phobia, specific phobia, generalized anxiety) were ascertained by a standardized psychiatric interview. Treatment for illegal drug use disorders and perceived unmet need for treatment were assessed among individuals with illegal drug use disorder. Odds of treatment and odds of perceived unmet need for treatment were assessed using logistic regression, adjusting for socio-demographic characteristics, treatment for mood and anxiety disorders, and comorbid alcohol use disorder.
Keywords: spasticity; pain; upper motor neuron syndrome; disorders of consciousness; brain injury; treatment
Following a severe brain injury, patients may suffer from disorders of consciousness (DOC), encompassing unresponsive wakefulness syndrome/vegetative state (UWS/VS)—meaning the patient shows awareness without any consciousness of self or the environment [ 1 ], minimally conscious state (MCS)—meaning the patient shows fluctuating behavioral signs of consciousness such as response to command or visual pursuit, or emergence from the minimally conscious state (EMCS)—meaning the patient is able to functionally communicate or use objects appropriately [ 2 ]. They often face a significant amount of functional, cognitive and motor impairment. By definition, these patients are unable to communicate, and therefore cannot express if they are uncomfortable or if they are suffering. This is why it is essential to detect and treat potential sources of pain, such as spasticity. Up to 89% of DOC patients suffer from spasticity, a motor disorder occurring following a lesion of the pyramidal tract [ 3 ]. This condition is usually defined as “a motor disorder, characterized by a velocity-dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerks, resulting from hyper-excitability of the stretch reflex as one component of the upper motor neuron (UMN) syndrome” [ 4 ]. Other associated symptoms are increased hypertonia, altered sensori-motor control and muscle spasms, scissoring
Vitamin D and musculoskeletal health, cardiovascular disease, autoimmunity and cancer: recommendations for clinical practice
Jean-Claude Souberbielle a ; Jean-Jacques Body b ; Joan M. Lappe c ; Mario Plebani d ; Yehuda Shoenfeld e ; Thomas J. Wang f ; Heike A. Bischoff-Ferrari g ; Etienne Cavalier h ; Peter R. Ebeling i ; Patrice Fardellone j ; Sara Gandini k ; Damien Gruson l ; Alain P. Guérin m ; Lene Heickendorff n ; Bruce W. Hollis o ; Sofia Ish-Shalom p ; Guillaume Jean q ; Philipp von Landenberg r ; Alvaro Largura s ; Tomas Olsson t ; Charles Pierrot-Deseilligny u ; Stefan Pilz v ; Angela Tincani w ; Andre Valcour x ; Armin Zittermann y
Catherine Bisbal a,b , Karen Lambert a,b and Antoine Avignon a,b,c
Excess body weight and type 2 diabetes (T2D) are at the forefront of the growing epidemic of chronic diseases. They are at the core of a great number of cardiovascular disorders that still represent the leading cause of mortality in most developed countries. Apart from their impact on health and well being, these conditions have a considerable economic cost (http://www.cdc.gov/nchs/ FASTATS/lcod.htm). Unfortunately, the burden of obesity and its associated complications is not limited to economically developed countries and is increasingly affecting economically developing countries . Diet and nutrition are key factors in the regulation of glucose metabolism. On the one hand, chronic overnu- trition is associated with insulin resistance. On the other hand, nutrition itself is a tool in regulating glucose metabolism, as it has been shown that some types of foods like the Mediterranean diet might be protective . The wealth of fruits and vegetables included in this diet, and consequently the supply of antioxidants, may be essential for its beneficial effects.
physiological microenvironment. However, the lack of a specific marker for HSCs to allow their targeting, the phase of the cell cycle in which HSCs reside, the limited volume per injection, and the number of HSCs required for targeting pose obstacles to the development of this technique. In mice, the IO injection of VSV-G pseudotyped LV particles has been reported to lead to only 2-3% of the peripheral blood cells being genetically modified . This may be a sufficiently high level for hemophilia A  or Fanconi anemia , but it is too low for the correction of hemoglobin disorders [218, 219]. Viral particles pseudotyped with vesicular stomatitis virus glycoprotein (VSV-G) can enter almost any cell type, due to the omnipresence of VSV-G receptors , and these particles are highly sensitive to complement-mediated degradation mechanisms . LVVs should therefore be engineered to target HSCs specifically and to be resistant to complement. In addition, activation of the G 0 /G 1 transition would
Definition and Diagnostic Criteria: Eating Disorders versus Disordered Eating
The conditions classically evoked as EDs are AN and bulimia nervosa (BN). These two major disorders, also called 'full ED' meet diagnostic criteria that are listed in DSM-IV manual of the American Psychiatric Association  and summarized in table 1. Diagnostic criteria stated slightly differently were proposed in the International Classification of Diseases (ICD) established by the WHO . For comparison purposes, they are also listed in table 1. Though AN and BN might be seen as opposing conditions, they share common characteristics including pursuit of thinness, fear of weight gain, and cognitive overinvestment of everything that refers to food. Quite frequently, anorectic girls fear becoming bulimic and bulimic girls hope for becoming anorectic. Forty to 50% of patients with AN develop BN after months or years .
Neuronal migration and disorders – an update Fiona Francis 1 , 2 , 3 and Silvia Cappello 4
This review highlights genes, proteins and subcellular mechanisms, recently shown to influence cortical neuronal migration. A current view on mechanisms which become disrupted in a diverse array of migration disorders is presented. The microtubule (MT) cytoskeleton is a major player in migrating neurons. Recently, variable impacts on MTs have been revealed in different cell compartments. Thus there are a multiplicity of effects involving centrosomal, microtubule- associated, as well as motor proteins. However, other causative factors also emerge, illuminating cortical neuronal migration research. These include disruptions of the actin cytoskeleton, the extracellular matrix, different adhesion molecules and signaling pathways, especially revealed in disorders such as periventricular heterotopia. These recent advances often involve the use of human in vitro models as well as model organisms. Focusing on cell-type specific knockouts and knockins, as well as generating omics and functional data, all seem critical for an integrated view on neuronal migration dysfunction.