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San Raffaele Cimena, Italy

Gobba F.,University of Modena and Reggio Emilia | Bacis M.,U.S.C. Medicina del Lavoro | Capodaglio E.,UO Neuroriabilitazione | De Michieli P.,University of Trieste | And 2 more authors.
Giornale Italiano di Medicina del Lavoro ed Ergonomia | Year: 2010

To date, scant attention has been devoted to the occupational risk related to repetitive movements in health personnel. Using three database, PubMed, Scopus, and EMBASE, we found 57 papers on this topic, and on possibly related upper limb symptoms and diseases. In these studies, evaluation of the risk, e.g. using the methods currently applied in industry, are lacking. Although in several studies data on the prevalence of upper limb symptoms and disorders are presented, a comparison of results is difficult as different methods were applied. Furthermore, a comparison with adequate controls is frequently lacking, andlor correlation with the risk was not studied. Despite these limitations, an overall evaluation of the results shows that in health personnel the prevalence of upper limb symptomsldisorders is generally high. Highest prevalences were observed for the neck, shoulder, wrist/hand symptoms and for Carpal Tunnel Syndrome (CTS) in dental personnel, for symptoms to the neck, shoulder and wrist/hand in sonographers, and to the neck, shoulder, elbow, and, especially, wrist/hand in laboratory technicians using manual pipettes. In the nursing personnel highly variable prevalences were observed; this is possibly due to the variability of the tasks performed by this occupational group. Repetitive movements of upper limb are a known risk factor for symptoms to the neck, shoulder, elbow, and wrist/hand, and some disorders, as CTS: the high prevalences observed in health workers may be related to this risk. Nevertheless, other factors such as effort, posture and precision work may play an important role too. As a conclusion, available data are insufficient for an adequate evaluation of the occupational risk related to repetitive movements in health workers. © PI-ME, Pavia 2010.

Capodaglio P.,Laboratorio Of Ricerca In Biomeccanica E Riabilitazione Ospedale San Giuseppe | Capodaglio E.M.,UO Neuroriabilitazione | Helmer P.,Laboratorio Of Ricerca In Biomeccanica E Riabilitazione Ospedale San Giuseppe | Vismara L.,Laboratorio Of Ricerca In Biomeccanica E Riabilitazione Ospedale San Giuseppe | And 3 more authors.
Giornale Italiano di Medicina del Lavoro ed Ergonomia | Year: 2011

In Italy, 42,5% of adult males is overweight and 10,5% obese, while 26,6% of the women is overweight and 9,1% obese. The economical consequences of a growing number of obese workers are relevant: obesity is associated to reduced participation to productive life, increased absenteeism, disability and need for health care, lower salaries, negative impact on productivity. The obese worker is characterized by reduced tolerance to effort, limited range of motion at spinal and joints level, reduced muscle strength normalized per body weight, lower tolerance to prolonged postures, reduced balance and overall reduced work capacity linear to the increase of body mass index. The present article reviews the most evident relationships between work factors (stress, musculoskeletal disorders etc) and obesity and speculates about possible interventions to prevent occupational issues for obese workers. © PI-ME, Pavia 2011.

Solaro C.,Dip. di Neurologia | Rezzani C.,Centro Of Ricerca Interdipartimentale Sulla Sclerosi Multipla Crism | Trabucco E.,Dip. di Neurologia | Amato M.P.,University of Florence | And 20 more authors.
Journal of the Neurological Sciences | Year: 2013

Objective: Multiple sclerosis (MS) is an inflammatory disease of the central nervous system(CNS)with a chronic course. Dysphagia represents one of the current challenges in clinical practice for the management of MS patients. Dysphagia starts to appear in mildly impaired MS subjects (EDSS 2-3) and becomes increasingly common in the most severely disabled subjects (EDSS 8-9). The aim of the present study was to evaluate the frequency and characteristics of patient-reported dysphagia inMS patientswith a multicenter study using the recently developed DYMUS (DYsphagia in MUltiple Sclerosis) questionnaire. Design: Data were collected in a multi-centre, cross-sectional study using a face-to-face structured questionnaire for clinical characteristics and the DYMUS questionnaire. Results: 1875 patients were interviewed. The current study has shown a correlation between patient-reported dysphagia and EDSS and disease course but notwith age, gender and disease duration.Questionnaireswere divided into "patient-reported dysphagia-yes" (587, 31.3%) and "patient-reported dysphagia-no" (1288, 68.7%). Compared with the patient-reported dysphagia-no group, patients in patient-reported dysphagia-yes group had higher EDSS score (mean EDSS 4.6 vs. 2.8; p < 0.001) and had a longer disease duration (mean duration 13 years vs. 11 years; p < 0.001), while there was no significant difference in gender (32.7% vs. 30.5% male and 67.3% vs. 69.5% female) and in age composition (46.18 vs. 42.05). Conclusions: This study represents the largest, multi-centre sample ofMS patients evaluated for patient-reported dysphagia utilizing an ad-hoc questionnaire for this condition. © 2013 Published by Elsevier B.V.

Fracchia S.,UO Neuroriabilitazione | Grasso A.,UO Neuroriabilitazione | Pagani M.,UO Neuroriabilitazione | Corsini C.,UO Neuroriabilitazione | And 8 more authors.
Giornale di Gerontologia | Year: 2011

Background and objectives. The use of Comprehensive Geriatric Assessment (GCA) reduces the adverse outcomes of hospitalization in the elderly. However. GCA utilizes "time-consuming" tools, which are unsuitable for an acute-care setting. We tested a new quick multidimensional assessment tool for older patients (ARM-A). We derived a Frailty Index (FI) by associating the items about the medical history and the 3-months mortality after discharge. The aim of the study was to verify the association between FI and the clinical complexity of the patients and between FI and the different outcomes of the hospitalization. Methods. We performed a prospective, cohort study in the Emergency Department of the Istituto Clinico Humanitas in Rozzano (Milan, Italy). We tested with ARM-A 60 patients aged 65 years or more. ARM-A is composed of 35 binary standardized items, which are defined by simple boolean algorithms, divided into 3 groups (Medical History, Marker of clinical complexity, Functional Dependence). We made a bivariable analysis, then a multivariable analysis to obtain the FI. Results. The main prognostic factors associated with 3-months mortality are active cancer, severe heart failure and disability in the IADL. The FI identifies patients with complex care needs, patients with an increased risk of functional decline [OR = 3.0; 95% IC = 1.5-6.2], and patients with an increased risk of institutionalization after discharge [OR = 3.3; 95% IC = 1.2-9.4]. Conclusions. ARM-A and the FI can be useful in identifying patients at increased risk and to improve the appropriateness of individual care.

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