The assessment of knowledge and application of proper body mechanics in the workplace

Back pain is the most expensive industrial injury. Representatives at DeRoyal, a manufacturer of orthopaedic soft goods, believed a total back hygiene program that included aggressive training in body mechanics would reduce the cost associated with back injury. Prior to implementing a back educational program, the knowledge base of employees was assessed. A survey designed to measure knowledge and application of proper body mechanics was developed and distributed to 100 randomly selected workers. Most workers know the best way to lift. But, they had less knowledge of the best way to push. They also did not always use proper technique in lifting without twisting, planning lifts, and proper standing. A subset of workers that has previously attended back training sessions (n = 6) all gave the correct answers on 4 or the 5 survey items. Orthopaedic nurses could play a critical role in the industrial setting through assessment of body mechanic knowledge and implementation of educational programs.

Posttraumatic chylous ascites in a child: recognition and management of an unusual condition

Chylous ascites is an extremely rare and often unrecognized complication of abdominal trauma in children. The management of this condition has traditionally been nonsurgical, but the success rate with nonoperative treatment is not always satisfactory. A case of posttraumatic chylous ascites in an abused toddler is presented, with emphasis on the diagnosis and treatment of this rare disorder.

Patterns of practice in emergency department management of chest pain of suspected cardiac origin: clinical utility of single stat creatine kinase (CK)

The patterns of practice and the clinical utility of a single stat creatine kinase (CK) level in the emergency department management of chest pain of suspected cardiac origin were examined by a prospective observational study using a two-part questionnaire, completed by physicians before and after availability of CK results. The results showed that of the 776 patients in the study, 135 were admitted to hospital with acute myocardial infarction (AMI), 285 were admitted for reasons other than AMI, 343 were discharged, and 13 died or were transferred to another hospital. Although initial and final diagnoses in the emergency department did not differ in 597 patients (77%), initial decisions to admit or discharge were made in only 244 (31%) patients without waiting for CK results, and in 401 (52%) cases, decisions on patient disposition were deferred. Of 218 patients who had elevated CK levels, 193 (89%) were admitted, 121 for AMI. Only five (< 1%) patients who would otherwise have been discharged were admitted because of elevated CK levels. Of the 343 discharges, 245 (71%) occurred after the physicians knew the CK results. It is concluded that emergency department physicians routinely make changes in their diagnostic and management decisions based on current information and as it becomes updated. This study also suggests that there appears to be a heavy reliance on a single CK assay, although the relative importance of this diagnostic test compared to other factors is not known. Further studies are necessary.

Gender differences in corpus callosum size in first-episode schizophrenics

Previous studies indicate differences between schizophrenics and normals in thickness and overall size of the corpus callosum, particularly in female subjects. The present study compares the area of the corpus callosum as measured by magnetic resonance imaging (MRI) in men and women experiencing first-episode cases of schizophrenia. The corpus callosum area is also correlated with measures of neuropsychological function. The results of this study suggest that women who are first-episode schizophrenic patients have a smaller total corpus callosum area than female controls, with no difference noted for men. In normal controls, a larger corpus callosum was associated with better cognitive function, whereas in schizophrenics, no such relationship emerged.

Comparison and significance of annual hydrochemical budgets in three small granitic catchments with contrasting vegetation (Mont-Lozere, France)

Chemical budgets are presented for three small granitic catchments in Southeastern France, with contrasting vegetation type: beech coppice; spruce forest; and grassland. The results show a small net loss of cations, and a large accumulation of sulphur in the soil, which acts as an additional proton sink. Significantly higher weathering rates are observed for the conifer catchment. Clearfelling of the spruce forest, late in the monitoring programme, increased net cation and nitrate losses. The importance of dry atmospheric deposition in the input-output budget, particularly for forests, is highlighted.

Measurement of gastric emptying rate in humans. Simplified scanning method

Simultaneous measurements of the gastric emptying rate of the solid and liquid phase of a dual-isotope-labeled test meal were made using a gamma camera and a simple scintillation detector, similar to that used in a hand-held probe. A simple scanning apparatus, similar to that used in a hand-held scintillation probe, was compared with simultaneous measurements made by a gamma camera in 16 healthy males. A dual-labeled test meal was utilized to measure liquid and solid emptying simultaneously. Anterior and posterior scans were taken at intervals up to 120 min using both a gamma camera and the scintillation probe. Good relative agreement between the methods was obtained both for solid-phase (correlation range 0.92-0.99, mean 0.97) and for liquid-phase data (correlation range 0.93-0.99, mean 0.97). For solid emptying data regression line slopes varied from 0.75 to 1.03 (mean 0.84). Liquid emptying data indicated that slopes ranged from 0.71 to 1.06 (mean 0.87). These results suggested that an estimate of the gamma measurement could be obtained by multiplying the scintillation measurement by a factor of 0.84 for the solid phase and 0.87 for the liquid phase. Correlation between repeat studies was 0.97 and 0.96 for solids and liquids, respectively. The application of a hand-held probe technique provides a noninvasive and inexpensive method for accurately assessing solid- and liquid-phase gastric emptying from the human stomach that correlates well with the use of a gamma camera, within the range of gastric emptying rate in the normal individuals in this study.

Fenestration of tenosynovial capillaries

A proportion of superficial capillaries in joint synovium are known to be fenestrated. The specialized functions of these fenestrated capillaries are unknown. We report the finding of fenestrae in tenosynovial capillaries from rabbit peroneal tendon sheaths. Fenestrations occupied 0.66% of the endothelial surface. Fenestrated capillaries appear to be a general feature of synovium, rather than a specific feature of joint tissue.