The Impact of Lead Aprons on Posture of Orthopaedic Surgeons

2020 ◽  
Author(s):  
Koroush Kabir ◽  
Kristian Welle ◽  
Sebastian Scheidt ◽  
Robert Ossendorf ◽  
Christian Prangenberg ◽  
...  
Keyword(s):  
Pressure Measurement ◽  
Thoracic Kyphosis ◽  
Average Duration ◽  
Trauma Surgery ◽  
Elderly Subjects ◽  
Foot Pressure ◽  
Lateral Deviation ◽  
Lead Apron ◽  
Duration Of Surgery ◽  
The Impact

Abstract Background Surgeons working in orthopedics and trauma surgery are frequently exposed to repetitive actions and non-ergonomic positions in their operative activities with the regular use of lead aprons. Musculoskeletal complaints of the neck and back among surgeons are reported in the literature as up to 80%. In this study, the effects of lead aprons on the posture of surgeons are examined using videorasterstereography, foot pressure measurement and questionnaires. Methodology All subjects (n = 31) were examined before and after exposure to wearing lead aprons during surgery using videorasterstereography and pedography. In addition, a survey with a separately created questionnaire and the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) was carried out. Results An average duration of lead apron use of 102.6 min showed an increase in forefoot load (p = 0.002) especially in the elderly subjects and thoracic kyphosis (p < 0.001) especially in the younger doctors with a significant lateral deviation (p = 0.006). In addition, the lateral deviation was shown to correlate with an increasing body size or a shorter period of employment (p = 0.008; r = 0.51/p = 0.026; r = − 0.44). Significantly fewer surgeons experienced back complaints on working days without lead apron use in the operating room compared to days in the OR (p = 0.011). Conclusion The impact of wearing front covered lead aprons during operations in the field of orthopaedics and trauma surgery leads to more frequent back complaints, even among young and healthy doctors. Under an average duration of surgery of 102 min a temporary postural deviation occurs that can be demonstrated by means of videorasterstereography and foot pressure measurement. The subjects showed a shifted weight distribution on the forefoot, a gain in thoracic kyphosis and an increase in lateral deviation, which also correlated with an increasing height and shorter length of employment.

scholarly journals Effects of COVID-19 on Facial Plastic and Reconstructive Surgery Fellowship Training and Director Practices

OTO Open ◽  
2021 ◽  
Vol 5 (2) ◽  
pp. 2473974X2110141
Author(s):  
Parsa P. Salehi ◽  
Sina J. Torabi ◽  
Yan Ho Lee ◽  
Babak Azizzadeh
Keyword(s):  
Facial Nerve ◽  
Reconstructive Surgery ◽  
Trauma Surgery ◽  
The United States ◽  
Fellowship Training ◽  
Craniofacial Surgery ◽  
Worker Safety ◽  
Plastic And Reconstructive Surgery ◽  
Facial Plastic ◽  
The Impact

Objectives The objectives of this study include characterizing the practice patterns and testing strategies of facial plastic and reconstructive surgery (FPRS) fellowship directors (FDs) secondary to COVID-19 and to quantify the impact of COVID-19 on FPRS fellowship training. Study Design Cross-sectional survey. Setting Online. Methods A survey was sent to all American Academy of Facial Plastic and Reconstructive Surgery FDs and co-FDs in September 2020. Descriptive analyses were performed. Results Of 77 eligible FDs, 45 responded (58.4%) representing a diverse group across the United States. All but 1 FD routinely screened patients for COVID-19 in the preoperative setting. FDs largely believed that universal preoperative testing was cost-effective (66.7%), improved patient safety (80.0%) and health care worker safety (95.6%), and was not burdensome for patients (53.3%). With regard to volume of cosmetic/aesthetic, reconstructive, facial nerve, and trauma surgery, FDs indicated largely no change in volume (34.9%, 71.0%, 68.4%, and 80.0%, respectively) or fellow experience (67.4%, 80.6%, 84.2%, and 80.0%). Half (50.0%) of the FDs reported decreased volume of congenital/craniofacial surgery, but 75.0% did not believe that there was a change in fellow experience. Overall, of the 15 responses indicating “worsened training” across all domains of FPRS, 14 were located in the Northeast (93.33%). Conclusions The COVID-19 pandemic has had the least impact on the volume of reconstructive procedures, facial nerve operations, and trauma surgery and a negative impact on congenital/craniofacial surgery volume, and it has accelerated the demand for cosmetic/aesthetic operations. Overall, the majority of FDs did not feel as though their fellows’ trainings would be adversely affected by the ongoing pandemic.

scholarly journals Resilience Against COVID-19: How Italy Faced the Pandemic in Pediatric Orthopedics and Traumatology

Children ◽  
2021 ◽  
Vol 8 (7) ◽  
pp. 530
Author(s):  
Giovanni Trisolino ◽  
Renato Maria Toniolo ◽  
Lorenza Marengo ◽  
Daniela Dibello ◽  
Pasquale Guida ◽  
...  
Keyword(s):  
Trauma Surgery ◽  
Nationwide Survey ◽  
Emergency Department Visits ◽  
Pediatric Orthopedics ◽  
Significant Drop ◽  
Surgical Interventions ◽  
Pediatric Orthopedic ◽  
Orthopedic Patients ◽  
The Impact ◽  
Second Wave

Background: We aimed to investigate the variation of medical and surgical activities in pediatric orthopedics in Italy, during the year of the COVID-19 pandemic, in comparison with data from the previous two years. The differences among the first wave, phase 2 and second wave were also analyzed. Methods: We conducted a retrospective multicenter study regarding the clinical and surgical activities in pediatric orthopedics during the pandemic and pre-pandemic period. The hospital databases of seven tertiary referral centers for pediatric orthopedics and traumatology were queried for events regarding pediatric orthopedic patients from 1 March 2018 to 28 February 2021. Surgical procedures were classified according to the “SITOP Priority Panel”. An additional classification in “high-priority” and “low-priority” surgery was also applied. Results: Overall, in 2020, we observed a significant drop in surgical volumes compared to the previous two years. The decrease was different across the different classes of priority, with “high-priority” surgery being less influenced. The decrease in emergency department visits was almost three-fold greater than the decrease in trauma surgery. During the second wave, a lower decline in surgical interventions and a noticeable resumption of “low-priority” surgery and outpatient visits were observed. Conclusion: Our study represents the first nationwide survey quantifying the impact of the COVID-19 pandemic on pediatric orthopedics and traumatology during the first and second wave.

scholarly journals Study on Companies from the Energy Sector from the Perspective of Performance through the Operating Cash Flow

Energies ◽  
2021 ◽  
Vol 14 (12) ◽  
pp. 3667
Author(s):  
Claudia Diana Sabău-Popa ◽  
Luminița Rus ◽  
Dana Simona Gherai ◽  
Codruța Mare ◽  
Ioan Gheorghe Țara
Keyword(s):  
Labor Productivity ◽  
Cash Flow ◽  
Stock Exchange ◽  
Average Duration ◽  
Significant Negative Correlation ◽  
Cash Flows ◽  
Energy Sector ◽  
Or Management ◽  
Operating Cash Flow ◽  
The Impact

In this paper we analyzed the link between companies’ performance, in terms of cash and income, and the labor productivity or management rates, in case of the companies from the energy sector listed on the Bucharest Stock Exchange. We focused on the energy sector because of the impact that its expansion has on the evolution of economies around the world and because of its dynamics in the sense of gradually shifting to the use of energy from renewable sources. We have used panel regression models to analyze the operating cash flow and the profitability rates and the determination of a causal or dependency relationship with labor productivity or management rates. The results of this study show a significant negative correlation between operating cash flows and the average duration of stock rotation, and no correlation between productivity and the operating cash flow. Instead, the average duration of stock turnover does not at all influence the profitability rates, and productivity is always significant for the return on assets, ie forthe return on equitywith a positive coefficient, as expected. The gap between the average duration of payment of suppliers and the average duration of receivables does not significantly influence neither the cash flow nor the rates of return.

scholarly journals The Impact of ‘Selfie’ Tourism on the Behaviour and Welfare of Brown-Throated Three-Toed Sloths

Animals ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. 216 ◽  
Author(s):  
Gemma Carder ◽  
Tinka Plese ◽  
Fernando Machado ◽  
Suzanne Paterson ◽  
Neil Matthews ◽  
...  
Keyword(s):  
Animal Welfare ◽  
Future Study ◽  
Average Duration ◽  
Wild Animal ◽  
Wild Animals ◽  
Different Types ◽  
Bradypus Variegatus ◽  
Focal Observation ◽  
The Impact ◽  
Physical Manipulation

The use of wild animals as photo props is prevalent across the globe and is widely recognised to represent a potential animal welfare concern. However, detailed information regarding the specific impacts of such activity on wild animal behaviour is currently lacking. Herein, we investigated how brown-throated three-toed sloths (Bradypus variegatus) were handled by tourists, and how sloths behaved during wildlife ‘selfies’ taken in Manaus, Brazil and Puerto Alegria and Iquitos in Peru. In total, we observed 17 sloths (during 70 focal observations) that were provided for use in wildlife selfies on 34 different tours. We found that an average number of 5 people held each sloth during each focal observation. For 48.6% of the time the sloths were handled in a way which involved physical manipulation of the sloths’ head and/or limbs and/or being held by the claws. From the eight different types of sloth behaviour observed, we found that the two types performed for the longest average duration of time were surveillance (55.3%) and limb stretching (12.6%). Our findings show that when being handled sloths were frequently held in ways that may compromise their welfare. Although to date the behaviour of sloths while being handled has not been reported in any published literature, in this study we document certain behaviours which may act as indicators of compromised welfare. We suggest that our data provides a potential baseline for future study into the behaviour and welfare of sloths.

scholarly journals HUBUNGAN PANDEMI COVID-19 DAN PSBB DENGAN GANGGUAN DEPRESI PADA LANSIA DI PANTI WREDA HANA CIPUTAT JAKARTA

2021 ◽  
Vol 1 (1) ◽  
pp. 66
Author(s):  
Anggun Tsabitah Rachmah ◽  
Noer Saelan Tadjudin
Keyword(s):  
Nursing Home ◽  
Large Scale ◽  
Depressive Disorders ◽  
The Elderly ◽  
Elderly Subjects ◽  
Research Subjects ◽  
Chi Square ◽  
Cross Sectional ◽  
The Government ◽  
The Impact

Pemerintah Indonesia selama pandemi COVID-19 menerapkan PSBB (Pembatasan Sosial Berskala Besar) dimana PSBB tersebut membuat aktivitas masyarakat dibatasi, dampaknya juga bisa dirasakan pada lansia di Panti Wreda sehingga dapat menyebabkan timbulnya gangguan depresi. Penelitian ini bertujuan untuk mengetahui hubungan pandemi COVID-19 dan PSBB dengan gangguan depresi pada lansia di Panti Wreda Hana Ciputat Jakarta. Penelitian ini menggunakan metode analitik observational dengan desain studi cross sectional. Penelitian ini dilakukan di Panti Wreda Hana Ciputat Jakarta terhadap lansia sejumlah 56 subjek penelitian yang terdiri dari perempuan 48 orang dan laki-laki 8 orang. Dari 56 subjek penelitian jumlah laki-laki 8 (14,3%) dan perempuan 48 (85,7%). Sebelum terjadinya pandemi COVID-19 dan PSBB, subjek penelitian yang tidak depresi sejumlah 49 subjek (87,5 %), kemungkinan besar depresi 6 subjek (10,7%), dan yang mengalami depresi 1 subjek (1,8%). Selama pandemi COVID19 dan PSBB, subjek penelitian yang tidak depresi 38 subjek (67,9%), kemungkinan besar depresi 14 subjek (25%), dan yang mengalami depresi 4 subjek (7,1%). Berdasarkan hasil uji Chi-square nilai p= 0,000. Dapat disimpulkan terdapat hubungan pandemi COVID-19 dan PSBB dengan gangguan depresi pada lansia di Panti Wreda Hana Ciputat Jakarta. The Government of Indonesia during the COVID-19 pandemic implemented PSBB (Large-Scale Social Restrictions) where the PSBB made community activities restricted, the impact can also be felt on the elderly in nursing home so that it can cause depressive disorders. This research was done in order to determine the relationship of the COVID-19 pandemic and PSBB with depressive disorders in the elderly at the Ciputat Hana Nursing Home in Jakarta. This study used an observational analytic method with a cross sectional study design. The research was conducted at the Ciputat Hana Nursing Home in Jakarta for 56 elderly subjects. In the nursing home consist of 48 women and 8 men. In 56 research subjects, there were 8 (14,3%) men and 48 (85,7%) women. Before the Pandemic of COVID-19 and PSBB, there were 49 (87,5%) research subjects who were not depressed, 6 (10,7%) research subjects who were most likely depressed, and 1 (1,8%) research subject who were depressed. During the Pandemic of COVID-19 and PSBB, there were 38 (67,9%) research subjects who were not depressed, 14 (25%) research subjects who were most likely depressed, and 4 (7,1%) research subjects who were depressed. Based on Chi-Square test result, the value of P = 0,000. In conclusion, there is a correlation between the pandemic of COVID-19 and PSBB with depression disorder in the elderly at Ciputat Hana Nursing Home in Jakarta.

scholarly journals A study of dynamic foot pressure measurement in diabetic patients

2017 ◽  
Vol 44 (2) ◽  
pp. 76 ◽  
Author(s):  
MilkaD Madhale ◽  
AshokS Godhi ◽  
NareshK Tyagi
Keyword(s):  
Pressure Measurement ◽  
Diabetic Patients ◽  
Foot Pressure

scholarly journals Identification of Biochemical and Molecular Markers of Early Aging in Childhood Cancer Survivors

2021 ◽  
Author(s):  
Silvia Ravera ◽  
Tiziana Vigliarolo ◽  
Silvia Bruno ◽  
Fabio Morandi ◽  
Danilo Marimpietri ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Childhood Cancer ◽  
Childhood Cancer Survivors ◽  
Antioxidant Defenses ◽  
Elderly Subjects ◽  
Cancer Type ◽  
Metabolism Regulation ◽  
Increased Risk ◽  
Early Aging ◽  
The Impact

ABSTRACTPurposeSurvival rates of Childhood Cancer Patients have improved tremendously over the past four decades. However, cancer treatments are associated with an increased risk of developing an anticipated onset of chronic diseases typical of aging. Thus, we aimed to identify molecular/metabolic cellular alterations responsible for early aging in Childhood Cancer Survivors (CCS).Patients and MethodsBiochemical, proteomic and molecular biology analyses were conducted on mononuclear cells (MNCs) isolated from peripheral blood of 196 CCS, comparing the results with those obtained on MNCs of 154 healthy subjects.ResultsData demonstrate that CCS-MNCs show: i) inefficient oxidative phosphorylation associated with low energy status and a metabolic switch to lactate fermentation compared with age-matched normal controls; ii) increment of lipid peroxidation due to an unbalance among the oxidative stress production and the activation of the antioxidant defenses; (iii) significantly lower expression of genes and proteins involved in mitochondrial biogenesis and metabolism regulation, such as CLUH, PGC1-α, and SIRT6 in CCS, not observed in the age-matched healthy or elderly subjects. The application of a mathematical model based on biochemical parameters predicts that CCS have a biological age significantly increased by decades compared to the chronological age. Overall, the results show that the impact of chemo/chemoradiotherapy on mitochondria efficiency in 196 CCS was rather homogeneous, irrespective of cancer type, treatment protocols, and time elapsed from the end of the curative period.ConclusionsOur study identifies some biochemical and molecular alterations possibly contributing to the pathophysiology of anticipated aging and metabolic deficiency described in CCS. These results may be useful in identifying approaches to restore the mitochondrial function, slowing down the aging and the associated pathological conditions in CCS.

A STUDY ON OUTCOME OF MINIMALLY INVASIVE PLATE OSTEOSYNTHESIS (MIPO) IN EXTRA ARTICULAR FRACTURE OF DISTAL 1/3RD TIBIA.

2021 ◽  
pp. 106-111
Author(s):  
Vaibhav Vaibhav
Keyword(s):  
Soft Tissue ◽  
Average Duration ◽  
Tibial Fractures ◽  
Categorical Variables ◽  
Minimal Risk ◽  
Distal Tibial Fractures ◽  
Non Union ◽  
Articular Fractures ◽  
Number Of Patients ◽  
Duration Of Surgery

BACKGROUND: Fractures of the distal tibia can be challenging to treat because of the limited soft tissue, the subcutaneous location, and poor vascularity. There is a considerable debate regarding the best method for treating distal tibial fractures. In present study we have treated distal tibial fractures using MIPPO technique OBJECTIVES: To evaluate the functional outcome following use of MIPO technique in lower 1/3rd fractures of tibia. MATERIAL AND METHODS: This is a longitudinal follow up study. In this study a total of 30 patients with fracture distal 1/3rd tibia admitted to CMRI hospital will be selected for treatment with MIPO technique according to inclusion and exclusion criteria. All patients were reviewed in CMRI Hospital and radiographs (Tibia AP and lateral views) obtained after surgery and then at 1 month, 3 months and nally at 6 months. From 5 weeks onwards symptoms and functions will be assessed using the scoring system of Olerud and Molander(1984). Statistical analysis of categorical variables was expressed as number of patients and percentage of patients and continuous variables are expressed as descriptive statistics. The statistical software SPSS version 20 has been used for the analysis. RESULTS: The age of patients ranged from 22-65 years. Fracture was most common in 4th and 5th decade of life. Average mean age was 44.03±10.74yrs. In this study majority of 17(56.7%) patients were male and there were 13(43.3%) were female. Road Trafc accident (RTA) was the main cause to produce lower end tibia fractures (83.3%) in our study. In this study right side (60%) was involved more than left (40%). In this study only 3 (10%) patients had open grade 1 injury. Majority of patients 27 (90%) had closed injury. In our study 66.67% (20) of patients had associated injuries and 33.33% patients had no associated injury. Average injury operation interval in this study was 3.27±1.53 days. Average no. of plate holes were 10.50±1.72. Average duration of hospital stay in this study was 10.07±2.75 days. Average duration of surgery in this study was 88.03±16.36 minutes. In this study 26 patients (86.7%) had no early post-op complications and 4 (13.3%) had complications. 3 patients (10%) had delayed wound healing and 1patient (3.3%) had supercial infection of suture lines. There was 1 non-union and majority of patients 21(70%) took 20-25 weeks for union. 7(23.4%) patients took less than 20 weeks and 1(3.33%) patient took more than 25 weeks. Average time of union in this study was 21.17±2.17 weeks. Average time of weight bearing was 17.72±1.91 weeks in this study. Most frequent late complication seen was swelling with frequency of 7 followed by stiffness and pain. 1 patient had malunion and 1 patient had non-union. In this study there were 28(93.3%) patients which showed union, 1 (3.3%) patient showed coronal malunion and 1(3.3%) had non-union. There were 21 patients (70 %) with excellent result, 7 patients (23.3%) with good result and 2 patients (6.7%) with fair result in our cases of study. Average clinical Olerud & Molander score was 81.17±16.07 in this study. CONCLUSION: The satisfactory functional results and lack of soft tissue complications suggest that this method should be considered in peri-articular fractures. Biological xation of complex fractures gives stable as well as optimal internal xation and complete recovery of limb function at an early stage with minimal risk of complications.

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