Cases Of Discomfort Research Articles

Cable plating with a single strut allograft in the treatment of periprosthetic fractures of the femur.

Hip arthroplasties are increasing worldwide resulting in an increasing number of periprosthetic fractures. These fractures are difficult to treat with various the different fixation or revision options described, many of which have high complication rates. To investigate whether our described method of treating periprosthetic fractures is an effective, safe and reproducible method of treating patients. We describe the largest series of a cable plate fixation system combined with a single cortical strut allograft to treat patients with periprosthetic fractures of the hip (Unified Classification System B1 and selected B2, C and D). Between July 2006 and March 2015, 28 patients were treated using this method. The mean follow-up was 2.2 years (3 months to 9 years). The mean Oxford Hip Score (OHS) at final follow-up was 32 and the mean modified Harris Hip Score (mHHS) 67. There were 3 complications including 1 failure that required revision surgery, 1 case of infection successfully treated with debridement, antibiotics and retention, and a case of discomfort from the metalwork which we managed conservatively. This method of anatomical restoration of the femur with dual-plane fixation is a highly effective method of treating this complex group of patients, and should be considered as a first line of treatment. It shows that there is a role for successful treatment with internal fixation of certain B2, C and D fractures with this technique.

The ergonomics of women in surgery

Among surgeons who regularly perform minimally invasive surgery, as many as 87 % report injuries or symptoms related to job performance. Operating room and instrument design have traditionally favored surgeons who are taller and who possess hands that are, in general, large and strong. We hypothesize that women may be experiencing more ergonomic difficulties than men for whom the operating room and surgical instruments, although uniformly perilous, more traditionally have accommodated. A 23-item web-based survey was offered via email to 2,000 laparoscopic surgeons and fellows currently practicing. The survey addressed four categories: demographics, physical symptoms, ergonomics, and environment/equipment. Key questions allowed us to identify which body part experienced which symptoms. There was a 15.7 % overall response rate. Among respondents, 17 % (54/314) were female. Women were significantly younger, shorter, had smaller glove size, and fewer years in practice than men surveyed (all p values < 0.0001). Of women reporting, 86.5 %—comparable to men—attribute physical discomfort to laparoscopic operating. Female surgeons are more likely to receive treatment for their hands, which includes the wrist, thumb, and fingers (odds ratio 3.5, p = 0.028). When men and women of the same glove size were compared, women with a larger glove size (7–8.5) reported more cases of treatment for their hands than men of the same glove size. (21 vs. 3 %, p = 0.016). Women who wore a size 5.5–6.5 surgical glove reported significantly more cases of discomfort in their shoulder area (neck, shoulder, upper back) than men who wore the same size surgical glove (77 vs. 27 %, p = 0.004). Women surgeons are experiencing more discomfort and treatment in their hands than male surgeons. Redesign of laparoscopic instrument handles and improvements to table height comprise the most promising solutions to these ergonomic challenges.

Physical discomfort and psychosocial job stress among male and female operators at telecommunication call centers in Taiwan

The prevalence of job stress, distributions of major job stressors, and associations between perceived job stress levels and multiple physical discomforts are assessed via a cross-sectional study of 1023 male and female operators at telecommunication call centers in Taiwan. Cases of discomfort are identified via questionnaire surveys requiring respondents to self-reported symptoms of discomfort. Information is obtained on demographics, health status, perceived job stress levels, major job stressors and psychosocial job characteristics. Multivariate logistic regression models are developed to predict physical discomfort in nine body areas. ‘Eye strain’, ‘hoarse or painful throat’ and ‘musculoskeletal discomfort’ are the most pronounced and prevalent complaints after prolonged work time at call centers. Female operators had higher prevalence of physical discomfort than male operators for all body areas. ‘Encountering difficult customers’ ranked as the most important job stress factor among both male and female operators. Working in a call center for more than 4 years is strongly associated with discomfort in all body areas (odds ratio ranges from 1.65 to 2.15). Analysis of risk factors vs. physical discomfort reveals that operators who perceive higher job stress have significantly increased risk of several health complaints, including eye strain, tinnitus, hoarse or painful throat, chronic cough with phlegm, chest tightness, irritable stomach or peptic ulcers, frequent urination and musculoskeletal discomfort.

Physical Discomfort Among Visual Display Terminal Users in a Semiconductor Manufacturing Company: A Study of Prevalence and Relation to Psychosocial and Physical/Ergonomic Factors

The associations among several alleged psychosocial and physical/ergonomics risk factors and the visual and musculoskeletal discomforts were assessed in a cross-sectional study of 119 video display terminal (VDT) users in a semiconductor manufacturing company. Cases of discomfort were identified using self-reported discomfort symptoms through questionnaire surveys. Data on individual, physical/ergonomic, and psychosocial aspects were obtained. Multivariate logistic regression models were developed to predict physical discomforts of 11 body areas. The prevalence of upper extremity discomfort found in this semiconductor manufacturing company was 42%, which is similar to the prevalence among VDT users in telecommunication companies and the newspaper industry. Full-time VDT users (data-entry personnel, programming engineers, and CAD engineers) had significantly higher rates of physical discomfort (66%) than part-time VDT users (fabrication engineers) (41%). Physical/ergonomic variables were found more dominant than psychosocial factors for visual and upper extremity discomforts. However, psychosocial variables were the dominant for back and lower extremity discomfort, when compared with the subjectively characterized physical/ergonomic factors. Because both physical/ergonomics variables and psychosocial factors and some of their interactions were associated with visual and musculoskeletal discomfort, integrating psychosocial prevention with physical/ergonomic design improvements is an effective approach to reducing the prevalence of discomfort.