Shoulder Disorders Related to Work Organization and Other Occupational Factors among Supermarket Cashiers

Abstract

The study was designed to examine, in 210 supermarket cashiers, the cross-sectional relationships between shoulder disorders according to location and chronicity of pain as well as personal and occupational factors and store and workstation characteristics. The factors associated with shoulder disorders differed for the right and left sides. Age and psychological disorders were significant risk factors. Among occupational factors, duration of employment, job control, wage dependence on efficiency, exposure to cold, movements and postures such as stooping, working with arms above shoulder level and holding heavy loads in position, and using a laser scanner were associated with shoulder disorders, especially on the left. These results confirm the multi factorial origin of shoulder disorders, and show the importance of psychosocial work factors, movements and postures, and the laser scanner as occupational risk factors, and the need to consider right and left shoulder disorders in cashiers separately.     

A Randomized,Double-Blind,Placebo-Controlled Trial of Oral Pregabalin for Relief of Shoulder Pain after Laparoscopic Gynecologic Surgery

Study ObjectiveTo investigate the efficacy of pregabalin for the relief of postoperative shoulder pain after laparoscopic gynecologic surgery.DesignProspective, randomized, double-blind, placebo-controlled trial (Canadian Task Force classification I).SettingTertiary referral center, university hospital.PatientsFifty-six women undergoing elective laparoscopic gynecologic surgery between June 2012 and March 2013.InterventionsWomen in the study group received 75 mg pregabalin 2 hours before surgery and then every 12 hours for 2 doses, and women in the control group received an identical capsule and the same dosage of placebo.Measurements and Main ResultsVisual analog scale (VAS) scores for shoulder pain and surgical pain at 24 and 48 hours after surgery were evaluated as primary outcome. Postoperative analgesics used and drug-related adverse events were also monitored. Patients in the pregabalin group had significantly lower postoperative VAS scores for shoulder pain at 24 hours, compared with the placebo group (median, 23.14 [range, 13.67–32.61] vs 37.22 [27.75–46.64]; p = .04), and required less analgesic (p = .01). There were no significant differences in VAS scores for surgical pain and adverse events between the 2 groups (p = .56).ConclusionsPerioperative administration of 75 mg pregabalin significantly reduced postoperative laparoscopic shoulder pain and amount of analgesic used.     

Kinematics of Chiropteran Shoulder Girdle in Flight

New data on the mechanisms of movements of the shoulder girdle and humerus of bats are described; potential mobility is compared to the movements actually used in flight. The study was performed on the basis of morphological and functional analysis of anatomical specimens of 15 species, high speed and high definition filming of two species and X‐ray survey of Rousettus aegyptiacus flight. Our observations indicate that any excursions of the shoulder girdle in bats have relatively small input in the wing amplitude. Shoulder girdle movements resemble kinematics of a crank mechanism: clavicle plays the role of crank, and scapula—the role of connecting rod. Previously described osseous “locking mechanisms” in shoulder joint of advanced bats do not affect the movements, actually used in flight. The wing beats in bats are performed predominantly by movements of humerus relative to shoulder girdle, although these movements occupy the caudal‐most sector of available shoulder mobility. Anat Rec, 296:382–394, 2013. © 2013 Wiley Periodicals, Inc.     

What would you do? Challenges in shoulder surgery

Dr. Evan Flatow moderates a panel of experts and discusses complex shoulder arthroplasty cases dealing with bone loss, malunions, arthroplasty revision, implant failure, and more. Panel includes Dr. Jon P. Warner, Dr. Gerald Williams, Dr. William Levine, Dr. William Seitz, and Dr. Evan Lederman.     

Convertible implants: Simplifying the revision from anatomic total shoulder arthroplasty to reverse total shoulder arthroplasty

Modern shoulder arthroplasty techniques include hemiarthroplasty, total shoulder arthroplasty (TSA), and reverse shoulder arthroplasty (RSA). Out of all arthroplasty procedures, total shoulder arthroplasty produces more satisfactory outcomes for osteoarthritis and inflammatory arthropathy (Sanchez-Sotelo, 2011 [1]). As shoulder arthroplasty procedures continue to increase in popularity, so do revision surgeries (revision TSAs and revision RSAs). Implants used in shoulder arthroplasty procedures have been transformed substantially from generation to generation, going from 1st to 4th generation implants. We propose 5th generation convertible implants that enable a more patient-specific, anatomic reconstruction with the potential to solve major issues that exist with implants from previous years.     

温通膏外敷联合中频电疗治疗冻结肩的疗效观察

目的:观察温通膏外敷联合中频电疗对冻结肩的临床疗效。方法:选取90例冻结肩病例,随机分为温通膏组、中频组,联合组。温通膏组使用温通膏外敷患者患处,中频组使用中频电疗,联合组则同时给予温通膏外敷及中频电疗治疗,三组均连续治疗10天。观察患者治疗前后的Constant-Murley肩关节评分中的疼痛评分、活动度评分,并于3个月后随访患者,记录复发情况。结果:治疗后,三组患者的肩关节Constant-Murley疼痛评分、活动度评分均高于治疗前(P<0.05);联合组患者的肩关节Constant-Murley疼痛评分、活动度评分明显优于温通膏组及中频组(P<0.05);治疗3个月后联合组的复发率(6.67%)明显低于其它两组。结论:温通膏联合中频电疗可以有效缓解冻结肩患者的疼痛,改善活动度,临床效果较单独使用温通膏外敷或中频电疗更优。     

冰冻棉棒涂擦刺激法用于脑卒中吞咽障碍早期护理的效果观察

目的：观察冰冻棉棒涂擦刺激法用于脑卒中吞咽障碍早期护理的效果。方法将86例脑卒中并发吞咽障碍患者，按住院号尾数分为观察组46例（单数）、对照组40例（双数），为两组患者制订详细的早期活动计划和方法。对照组进行常规训练护理30d，观察组患者在进行常规训练护理基础上结合咽部冷刺激30d，观察两组患者治疗前后吞咽障碍改变的程度，误吸的发生数及并发症发生率。结果观察组治疗前后的饮水试验结果、临床疗效均优于对照组。结论冰冻棉棒涂擦刺激法用于脑卒中吞咽障碍早期护理，能促进患者吞咽功能恢复，减少并发症发生。