Ergonomic risk assessment of working postures of nurses working in a medical faculty hospital with REBA and RULA methods

The aim of the study is to reach objective results about the ergonomic risks of nurses' working postures not only by using questionnaires but also by using Rapid Entire Body Assessment (REBA) and Rapid Upper Limb Assessment (RULA) methods, which are risk assessment methods used in engineering fields. This study is a cross-sectional study. First of all, 383 nurses were evaluated with a survey. 91.4% of the nurses were women and 6.5% were men. Average age (female: 38.20; male: 31.5), average weight (female: 65.60 kg; male: 81.50 kg), average height (female: 162.7 cm; male: 176.80 cm) and average body mass index (female: 24.80; male: 26) were calculated. In the hospital, which we grouped into in the hospital, which we divided into eight workstations, the REBA and RULA scores of the three nurses working at each workstation were calculated and the average REBA and RULA scores of the workstations were determined. The percentage of those who experienced musculoskeletal pain in the last 1 year at each workstation and the mean REBA-RULA scores were as follows; ward (92%; 6.92-5.69), operating room (98%; 10-7), emergency department (100%; 6.08-5.33), outpatient clinic (75%; 5.5-5.16), intensive care (94%; 6.21-5.57), administrative affairs (94%; 5-5), laboratory (95%; 5.80-5.2) and interventional procedure (92%; 6.4-5.4). In these stations, the highest scores were seen in the operating room. In the questionnaire, 92.46% of the nurses reported having complaints in at least one part of the musculoskeletal system in the last year. The hospital weighted mean score was REBA 6.86 and RULA 5.71. When REBA and RULA measurements were evaluated, it was determined that the risk in the departments where the nurses worked was generally at the medium risk level. REBA and RULA scores indicate that ergonomic changes and adjustments should be made. For this determination, the risks of working postures should be determined with quantitative methods.

Prevalence and etiology of molar-incisor hypomineralization (MIH) in the city of Istanbul

Background/purpose

Molar-Incisor-Hypomineralisation (MIH) is the term used to depict a condition in which one or more of the permanent molar teeth and usually no less than one incisor tooth is hypomineralised and the prevalence rates vary from 2.4 to 40.2%. The aim of this study was to assess the prevalence and the risk factors of MIH in children in Istanbul, Turkey.

Materials and methods

A total of 1511 (760 M, 751 F), 8- to 11-year-old children were examined who had their first permanent molar and incisors evaluated using the EAPD criteria for MIH. Hypomineralized molars and incisors were recorded based on developmental defects of enamel index. The potential aetiological factors were retrieved through personal interview and etiological questions were asked to the parents. Statistical analysis was performed with a chi-Square test.

Results

MIH was observed in 215 (14.2%; 102 male, 113 female) children. The sample (1511 children) comprised 71 (9.9%) 8 year-olds with MIH and 144 (18.2%) 11 year-olds with MIH. A significant difference was found between 8 (9.9%) and 11-year-old (18.2%) children with MIH (p ≤ 0.001). Complications during the mother's pregnancy, birth prematurity, average breast feeding period, diarrhea frequency, digestive system diseases, asthma, frequent high fever, ear infection, renal failure, rubeola, chickenpox and parotitis were found to be significantly associated with MIH (p < 0.001).

Conclusion

There are many events that can cause MIH which we cannot control or predict. Therefore, longitudinal studies with large sample size are needed so as to determine how various likely etiological factors described affect the etiological role.

The usefulness of agent emission imaging - high mechanical index ultrasound mode in the diagnosis of urolithiasis: a prospective preliminary study

PURPOSE

We aimed to determine the feasibility and effectiveness of agent emission imaging - high mechanical index (AEI-High MI) mode ultrasonography (US) compared with gray-scale and color Doppler US, alone or in combination, for the diagnosis of urolithiasis with reference to unenhanced computed tomography (CT).

METHODS

This prospective study included 72 consecutive patients (40 males, 32 females; mean age, 45.9±14.7 years) referred by the department of urology for acute or elective symptoms of urolithiasis and confirmed to have urinary calculi on unenhanced abdominal CT, between January 2015 and June 2015. Gray-scale, color Doppler, and AEI-High MI US were performed by two radiologists to determine the effectiveness of these methods in the diagnosis of urinary stones and to compare them with the reference modality.

RESULTS

A total of 189 calculi were detected on CT examination. Gray-scale US had a sensitivity of 66.1% and positive predictive value (PPV) of 88.7% for detecting calculi, while twinkling artifact of color Doppler had a sensitivity of 70.4% and PPV of 94.3%. The scintillation artifact of AEI-High MI mode had a sensitivity of 75.1% and PPV of 95.9%. When all ultrasound-based modalities were combined, the sensitivity and PPV rose to 83.1% and 88.2%, respectively. When calculi were grouped according to their size ( < 5 mm, 5-10 mm, > 10 mm), AEI-High MI mode had a higher sensitivity (60%) compared with gray-scale (32.5%) and color Doppler (41.3%) for calculi < 5 mm.

CONCLUSION

AEI-High MI mode had a higher sensitivity compared with gray-scale and color Doppler for the detection of calculi smaller than 5 mm, but it did not make a significant contribution to detection of larger calculi. The combined use of gray-scale US with AEI-High MI mode could increase the detection rate of calculi smaller than 5 mm and provide a method for verification of suspected calculi on gray-scale US.

Comparative evaluation of various miniplate systems for the repair of mandibular corpus fractures

Miniplates have been used during the last decade to facilitate stability between bony fragments in the maxillofacial region and are currently the preferred surgical method for the fixation of fractures and osteotomies. The aim of this study was to evaluate and compare the biomechanical behaviors of six different types of miniplates used to reconstruct mandibular body fractures: Group 1 (straight, 2 holes, 12.0 mm spacing), Group 2 (straight, 4 holes, 9.0 spacing), Group 3 (straight, 6 holes, 9.0 mm spacing), Group 4 (L-shaped, 4 holes, 9.0 mm spacing, right hand plate), Group 5 (Y-shaped, 5 holes, 12.0 mm spacing), and Group 6 (double Y-shaped, 6 holes, 9.0 mm spacing). Thirty bovine hemimandibles and a custom-made 3-point biomechanical test frame mounted on a Shimadzu universal test machine were used to evaluate the six different miniplate systems. Results revealed that Group 1 (straight, 2 holes, 12.0 mm spacing) and Group 4 (9.0 mm spacing, right hand plate) had the lowest biomechanical stability, whereas Group 6 (6 holes, 9.0 mm spacing) had the highest biomechanical stability. Group 6 also provided statistically greater resistance to displacement than Group 1 and Group 4.

Can diffusion-weighted MRI determine complete responders after neoadjuvant chemoradiation for locally advanced rectal cancer?

PURPOSE

We aimed to prospectively determine if analyzing pre- and post-chemoradiotheraphy (CRT) changes in the signal intensity (SI) and apperent diffusion coefficient (ADC) values from diffusion-weighted magnetic resonance imaging (DW-MRI) can accurately predict complete responders for locally advanced rectal cancer.

MATERIALS AND METHODS

Thirty patients (mean age, 54.3 years) with locally advanced rectal cancer who underwent neoadjuvant CRT and subsequent surgery were included in this study. All patients were evaluated pre- and post-CRT by standardized turbo spin echo and DW-MRI. Pre- and post-CRT tumor and normal rectal wall SI (which were gradually scored as very high, high, intermediate, low, and no signal) and ADC values were recorded.

RESULTS

Tumor SIs were decreased in all of the patients that had a therapy response. However, complete tumor SI loss was only seen in two (22.2%) of nine patients with a pathological complete response, while it regressed to low and/or intermediate SI levels in the remaining seven patients (77.8%). Post-CRT ADC values of rectal tumors were significantly higher from the preCRT ADC values (P < 0.0001; Z=-9.39). However, post-CRT ADC values from the complete and partial/no response patient groups were not significantly different (P = 0.071; Z=-1.99).

CONCLUSION

In re-staging of rectal tumors by DW-MRI, an increase in ADC values and decrease in SIs can predict therapy response but cannot unequivocally determine a complete response.

Respiratory health symptoms among students exposed to different levels of air pollution in a Turkish city

In this study, we aimed to investigate the frequency of respiratory health symptoms among high school students attending schools at industrial, urban and rural areas in a Turkish city. Three schools located in different zones of the city having different pollution characteristics were chosen based on the pollutant distribution maps using Geographical Information Systems (GIS) software. A cross-sectional survey was performed among 667 high school students in the schools. Outdoor and indoor nitrogen dioxide (NO(2)) and ozone (O(3)) concentrations were also measured by passive samplers in the same schools to investigate possible routes of exposure. Chronic pulmonary disease (OR = 1.49; 95%CI: 1.11-1.99; p = 0.008), tightness in the chest (OR = 1.57; 95%CI: 1.22-2.02; p = 0.001), morning cough (OR = 1.81 95%CI: 1.19-2.75; p = 0.006) were higher among students in the industrial zone where nitrogen dioxide and ozone levels were also highest. There were no indoor sources of nitrogen dioxide and ozone exists in the schools except for the dining hall. As a conclusion, this study has noticed that air pollution and respiratory health problems among high school students are high in industrial zones and the use of passive samplers combined with GIS is an effective tool that may be used by public health researchers to identify pollutant zones and persons at risk.