Sample records for decompression sickness

  1. Decompression sickness in caisson workers (United States)

    Ghawabi, Samir H. El; Mansour, Mohamed B.; Youssef, Fatma L.; Ghawabi, Mohamed H. El; Latif, Mohamed M. Abd El


    El Ghawabi, S. H., Mansour, M. B., Youssef, F. L., El Ghawabi, M. H., and Abd El Latif, M. M. (1971).Brit. J. industr. Med.,28, 323-329. Decompression sickness in caisson workers. An investigation of 55 bridge construction workers is reported. The overall bends rate was 0·97%. (The term `bends' as used in this study is defined in the paper.) Chokes were encountered in 67·27% of workers. A clinical, haematological, and radiological study was performed. Definite bony changes were found in 43·6% of all workers; 91·6% of these had lesions around the elbow. The presence of dense areas in the neck of the scapula is reported in two cases for the first time. The relatively high haematocrit value is thought to play a part in the pathogenesis of bone infarction through its relation with blood viscosity. Images PMID:5124832

  2. Identifying the Subtle Presentation of Decompression Sickness. (United States)

    Alea, Kenneth


    Decompression sickness is an inherent occupational hazard that has the possibility to leave its victims with significant long-lasting effects that can potentially impact an aircrew's flight status. The relative infrequency of this hazard within the military flying community along with the potentially subtle presentation of decompression sickness (DCS) has the potential to result in delayed diagnosis and treatment, leading to residual deficits that can impact a patient's daily life or even lead to death. The patient presented in this work was diagnosed with a Type II DCS 21 h after a cabin decompression at 35,000 ft (10,668 m). The patient had been asymptomatic with a completely normal physical/neurological exam following his flight. The following day, he presented with excessive fatigue and on re-evaluation was recommended for hyperbaric therapy, during which his symptoms completely resolved. He was re-evaluated 14 d later and cleared to resume flight duties without further incident. The manifestation of this patient's decompression sickness was subtle and followed an evaluation that failed to identify any focal findings. A high index of suspicion with strict follow-up contributed to the identification of DCS in this case, resulting in definitive treatment and resolution of the patient's symptoms. Determination of the need for hyperbaric therapy following oxygen supplementation and a thorough history and physical is imperative. If the diagnosis is in question, consider preemptive hyperbaric therapy as the benefits of treatment in DCS outweigh the risks of treatment. Finally, this work introduces the future potential of neuropsychological testing for both the diagnosis of DCS as well as assessing the effectiveness of hyperbaric therapy in Type II DCS.

  3. The probability and severity of decompression sickness (United States)

    Hada, Ethan A.; Vann, Richard D.; Denoble, Petar J.


    Decompression sickness (DCS), which is caused by inert gas bubbles in tissues, is an injury of concern for scuba divers, compressed air workers, astronauts, and aviators. Case reports for 3322 air and N2-O2 dives, resulting in 190 DCS events, were retrospectively analyzed and the outcomes were scored as (1) serious neurological, (2) cardiopulmonary, (3) mild neurological, (4) pain, (5) lymphatic or skin, and (6) constitutional or nonspecific manifestations. Following standard U.S. Navy medical definitions, the data were grouped into mild—Type I (manifestations 4–6)–and serious–Type II (manifestations 1–3). Additionally, we considered an alternative grouping of mild–Type A (manifestations 3–6)–and serious–Type B (manifestations 1 and 2). The current U.S. Navy guidance allows for a 2% probability of mild DCS and a 0.1% probability of serious DCS. We developed a hierarchical trinomial (3-state) probabilistic DCS model that simultaneously predicts the probability of mild and serious DCS given a dive exposure. Both the Type I/II and Type A/B discriminations of mild and serious DCS resulted in a highly significant (p probability of ‘mild’ DCS resulted in a longer allowable bottom time for the same 2% limit. However, for the 0.1% serious DCS limit, we found a vastly decreased allowable bottom dive time for all dive depths. If the Type A/B scoring was assigned to outcome severity, the no decompression limits (NDL) for air dives were still controlled by the acceptable serious DCS risk limit rather than the acceptable mild DCS risk limit. However, in this case, longer NDL limits were allowed than with the Type I/II scoring. The trinomial model mild and serious probabilities agree reasonably well with the current air NDL only with the Type A/B scoring and when 0.2% risk of serious DCS is allowed. PMID:28296928

  4. You’re the Flight Surgeon: Pulmonary Decompression Sickness (United States)


    follow-up of this patient Diagnosis: Decompression sickness (DeS) with pulmonary symptoms (Type Il DeS, older nomenclature). Treatment: Hyperbaric quite clear thai any case of suspected decompression sickness in the USAF be discussed with the hyperbariC medicine specialists at Brooks City...physician in as respectful manner as you can that you suspect the patient’s condition is likely related to his hypobaric exposure. B. Agree with

  5. Decompression sickness in breath-hold divers: a review. (United States)

    Lemaitre, Frederic; Fahlman, Andreas; Gardette, Bernard; Kohshi, Kiyotaka


    Although it has been generally assumed that the risk of decompression sickness is virtually zero during a single breath-hold dive in humans, repeated dives may result in a cumulative increase in the tissue and blood nitrogen tension. Many species of marine mammals perform extensive foraging bouts with deep and long dives interspersed by a short surface interval, and some human divers regularly perform repeated dives to 30-40 m or a single dive to more than 200 m, all of which may result in nitrogen concentrations that elicit symptoms of decompression sickness. Neurological problems have been reported in humans after single or repeated dives and recent necropsy reports in stranded marine mammals were suggestive of decompression sickness-like symptoms. Modelling attempts have suggested that marine mammals may live permanently with elevated nitrogen concentrations and may be at risk when altering their dive behaviour. In humans, non-pathogenic bubbles have been recorded and symptoms of decompression sickness have been reported after repeated dives to modest depths. The mechanisms implicated in these accidents indicate that repeated breath-hold dives with short surface intervals are factors that predispose to decompression sickness. During deep diving, the effect of pulmonary shunts and/or lung collapse may play a major role in reducing the incidence of decompression sickness in humans and marine mammals.

  6. MRI diagnosis of acute spinal cord decompression sickness

    International Nuclear Information System (INIS)

    Tang Xiaofeng; Yuan Fengmei; Ma Heng; Xu Yongzhong; Gai Qingzhu; Wang Ying


    Objective: To describe MRI findings of acute spinal cord decompression sickness. Methods: MRI findings of 5 cases with clinical definite acute spinal cord decompression sickness were retrospectively analyzed. The main clinical informations included underwater performance history against regulations, short-term complete or incomplete spinal cord injury symptoms after fast going out of water, sensory disability and urinary and fecal incontinence, etc. Results: Spinal cord vacuole sign was found in all 5 cases. Iso-signal intensity (n=3), high signal intensity (n=1), and low signal intensity (n=1) was demonstrated on T 1 WI, and high signal intensity (n=5) was found on T 2 WI. Owl eye sign was detected in 3 cases, and lacune foci were seen in 2 cases. Conclusion: MRI findings of acute spinal cord decompression sickness had some characteristics, and it was easy to diagnose by combining diving history with clinical manifestations. (authors)

  7. Health care worker decompression sickness: incidence, risk and mitigation. (United States)

    Clarke, Richard


    Inadvertent exposure to radiation, chemical agents and biological factors are well recognized hazards associated with the health care delivery system. Less well appreciated yet no less harmful is risk of decompression sickness in those who accompany patients as inside attendants (IAs) during provision of hyperbaric oxygen therapy. Unlike the above hazards where avoidance is practiced, IA exposure to decompression sickness risk is unavoidable. While overall incidence is low, when calculated as number of cases over number of exposures or potential for a case during any given exposure, employee cumulative risk, defined here as number of cases over number of IAs, or risk that an IA may suffer a case, is not. Commonly, this unique occupational environmental injury responds favorably to therapeutic recompression and a period of recuperation. There are, however, permanent and career-ending consequences, and at least two nurses have succumbed to their decompression insults. The intent of this paper is to heighten awareness of hyperbaric attendant decompression sickness. It will serve as a review of reported cases and reconcile incidence against largely ignored individual worker risk. Mitigation strategies are summarized and an approach to more precisely identify risk factors that might prompt development of consensus screening standards is proposed. Copyright© Undersea and Hyperbaric Medical Society.

  8. Decompression Sickness during Construction of the Dartford Tunnel (United States)

    Golding, F. Campbell; Griffiths, P.; Hempleman, H. V.; Paton, W. D. M.; Walder, D. N.


    A clinical, radiological and statistical survey has been made of decompression sickness during the construction of the Dartford Tunnel. Over a period of two years, 1,200 men were employed on eight-hour shifts at pressures up to 28 pounds per square inch (p.s.i.). There were 689 cases of decompression sickness out of 122,000 compressions, an incidence of 0·56%. The majority of cases (94·9%) were simple “bends”. The remainder (5·1%) exhibited signs and symptoms other than pain and were more serious. All cases were successfully treated and no fatality or permanent disability occurred. In two serious cases, cysts in the lungs were discovered. It is suggested that these gave rise to air embolism when the subjects were decompressed, and pulmonary changes may contribute more than hitherto believed to the pathogenesis of bends. Some other clinical features are described, including “skin-mottling” and an association between bends and the site of an injury. The bends rate is higher for the back shift (3 p.m. to 11 p.m.) and the night shift (11 p.m. to 7 a.m.) than for the day shift. In the treatment of decompression sickness it appears to be more satisfactory to use the minimum pressure required for relief of symptoms followed by slow decompression with occasional “soaks”, than to attempt to drive the causative bubbles into solution with high pressures. During the contract the decompression tables recently prescribed by the Ministry of Labour were used. Evidence was obtained that they could be made safer, and that the two main assumptions on which they are based (that sickness will not occur at pressures below 18 p.s.i., and that a man saturates in four hours) may be incorrect. It is desirable to test tables based on 15 p.s.i. and eight-hour saturation. The existence of acclimatization to pressure was confirmed; it is such that the bends rate may fall in two to three weeks to 0·1% of the incidence on the first day of exposure. Acclimatization is lost again

  9. A Log Logistic Survival Model Applied to Hypobaric Decompression Sickness (United States)

    Conkin, Johnny


    Decompression sickness (DCS) is a complex, multivariable problem. A mathematical description or model of the likelihood of DCS requires a large amount of quality research data, ideas on how to define a decompression dose using physical and physiological variables, and an appropriate analytical approach. It also requires a high-performance computer with specialized software. I have used published DCS data to develop my decompression doses, which are variants of equilibrium expressions for evolved gas plus other explanatory variables. My analytical approach is survival analysis, where the time of DCS occurrence is modeled. My conclusions can be applied to simple hypobaric decompressions - ascents lasting from 5 to 30 minutes - and, after minutes to hours, to denitrogenation (prebreathing). They are also applicable to long or short exposures, and can be used whether the sufferer of DCS is at rest or exercising at altitude. Ultimately I would like my models to be applied to astronauts to reduce the risk of DCS during spacewalks, as well as to future spaceflight crews on the Moon and Mars.

  10. Spinal decompression sickness: mechanical studies and a model. (United States)

    Hills, B A; James, P B


    Six experimental investigations of various mechanical aspects of the spinal cord are described relevant to its injury by gas deposited from solution by decompression. These show appreciable resistances to gas pockets dissipating by tracking along tissue boundaries or distending tissue, the back pressure often exceeding the probable blood perfusion pressure--particularly in the watershed zones. This leads to a simple mechanical model of spinal decompression sickness based on the vascular "waterfall" that is consistent with the pathology, the major quantitative aspects, and the symptomatology--especially the reversibility with recompression that is so difficult to explain by an embolic mechanism. The hypothesis is that autochthonous gas separating from solution in the spinal cord can reach sufficient local pressure to exceed the perfusion pressure and thus occlude blood flow.

  11. Protective effects of fluoxetine on decompression sickness in mice.

    Directory of Open Access Journals (Sweden)

    Jean-Eric Blatteau

    Full Text Available Massive bubble formation after diving can lead to decompression sickness (DCS that can result in central nervous system disorders or even death. Bubbles alter the vascular endothelium and activate blood cells and inflammatory pathways, leading to a systemic pathophysiological process that promotes ischemic damage. Fluoxetine, a well-known antidepressant, is recognized as having anti-inflammatory properties at the systemic level, as well as in the setting of cerebral ischemia. We report a beneficial clinical effect associated with fluoxetine in experimental DCS. 91 mice were subjected to a simulated dive at 90 msw for 45 min before rapid decompression. The experimental group received 50 mg/kg of fluoxetine 18 hours before hyperbaric exposure (n = 46 while controls were not treated (n = 45. Clinical assessment took place over a period of 30 min after surfacing. At the end, blood samples were collected for blood cells counts and cytokine IL-6 detection. There were significantly fewer manifestations of DCS in the fluoxetine group than in the controls (43.5% versus 75.5%, respectively; p = 0.004. Survivors showed a better and significant neurological recovery with fluoxetine. Platelets and red cells were significantly decreased after decompression in controls but not in the treated mice. Fluoxetine reduced circulating IL-6, a relevant marker of systemic inflammation in DCS. We concluded that fluoxetine decreased the incidence of DCS and improved motor recovery, by limiting inflammation processes.

  12. 2014 Decompression Sickness/Extravehicular Activity Risks Standing Review Panel (United States)

    Steinberg, Susan; Mahon, Richard; Klaus, David; Neuman, Tom; Pilmanis, Andrew; Regis, David


    The 2014 Decompression Sickness (DCS)/Extravehicular Activity (EVA) Risks Standing Review Panel (from here on referred to as the SRP) met for a site visit in Houston, TX on November 4 - 5, 2014. The SRP reviewed the Research Plans for The Risk of Decompression Sickness and the Risk of Injury and Compromised Performance due to EVA Operations, as well as the Evidence Reports for both of these Risks. The SRP found that the NASA DCS/EVA team did an excellent job of presenting their research plans. The SRP considers it critical that NASA proceeds with the high priority tasks identified in this report (DCS1, DCS3, DCS5). The highest priority is to determine the acceptable DCS and hypoxia risk associated with the planned human exploration beyond low Earth orbit. The risk of DCS is highly dependent upon the pressure within the exploration vehicle. If slightly more hypoxia is permitted then (even with the same percentage of oxygen) the pressure within the exploration vehicle can be lowered thus further mitigating the risk of DCS. The second highest priority is to test and validate the recommended 8.2psi/34% O2 atmosphere. Development of procedures and equipment for human exploration missions are very limited until the results of this testing are completed. The SRP also suggests that DCS7 be separated into two Gaps. Gap DCS7 should deal with DCS treatment while a new Gap should be created to deal with the long-term effects of DCS. The SRP also encourages NASA to increase collaboration with other organizations and pool resources where possible. The current NASA DCS/EVA team has the extensive expertise and a wealth of knowledge in this area. The SRP suggests that increased manpower for this team would be highly productive.

  13. The Mars Project: Avoiding Decompression Sickness on a Distant Planet (United States)

    Conkin, Johnny


    A cost-effective approach for Mars exploration is to use available resources, such as water and atmospheric gases. Nitrogen (N2) and argon (Ar) are available and could form the inert gas component of a habitat atmosphere at 8.0, 9.0, or 10.0 pounds per square inch (psia). The habitat and space suit are designed as an integrated system: a comfortable living environment about 85% of the time and a safe working environment about 15% of the time. A goal is to provide a system that permits unrestricted exploration of Mars, but the risk of decompression sickness (DCS) during the extravehicular activity in a 3.75-psia suit, after exposure to any of the three habitat conditions, may limit unrestricted exploration. I evaluate here the risk of DCS since a significant proportion of a trinary breathing gas in the habitat might contain Ar. I draw on past experience and published information to extrapolate into untested, multivariable conditions to evaluate risk. A rigorous assessment of risk as a probability of DCS for each habitat condition is not yet possible. Based on many assumptions about Ar in hypobaric decompressions, I conclude that the presence of Ar significantly increases the risk of DCS. The risk is significant even with the best habitat option: 2.56 psia oxygen, 3.41 psia N2, and 2.20 psia Ar. Several hours of prebreathing 100% 02, a higher suit pressure, or a combination of other important variables such as limited exposure time on the surface or exercise during prebreathe would be necessary to reduce the risk of DCS to an acceptable level. The acceptable level for DCS risk on Mars has not yet been determined. Mars is a great distance from Earth and therefore from primary medical care. The acceptable risk would necessarily be defined by the capability to treat DCS in the Rover vehicle, in the habitat, or both.

  14. Habitat Options to Protect Against Decompression Sickness on Mars (United States)

    Conkin, J.


    Men and women are alive today, although perhaps still in diapers, who will explore the surface of Mars. Two achievable goals to enable this exploration are to use Martian resources, and to provide a safe means for unrestricted access to the surface. A cost-effective approach for Mars exploration is to use the available resources, such as water and atmospheric gases. Nitrogen (N2) and Argon (Ar) in a concentration ratio of 1.68/1.0 are available, and could form the inert gas component of a habitat atmosphere at 8.0, 9.0, or 10.0 pounds per square inch absolute (psia). The habitat and space suit must be designed as an integrated, complementary, system: a comfortable living environment about 85% of the time and a safe working environment about 15% of the time. A goal is to provide a system that permits unrestricted exploration of Mars. However the risk of decompression sickness (DCS) during the extravehicular activity (EVA) in a 3.75 psia suit after exposure to either of the three habitat conditions may limit unrestricted exploration.

  15. Inner ear decompression sickness in compressed-air diving. (United States)

    Klingmann, Christoph


    Inner ear decompression sickness (IEDCS) has become more frequently reported in recreational diving. We examined 34 divers after IEDCS and analyzed their dive profiles, pattern of symptoms, time of symptom onset and the association with a right-to left shunt (r/l shunt). Four divers used mixed gas and were excluded from the analysis. Of the remaining 30 divers, 25 presented with isolated IEDCS alone, while five divers had additional skin and neurological symptoms. All divers presented with vertigo (100%), and 12 divers reported additional hearing loss (40%). All symptoms occurred within 120 minutes (median 30 minutes) of ascent. Twenty-two of 30 divers (73.3%) showed a r/l shunt. A possible explanation for the frequent association of a r/l shunt and the dominance of vestibular rather than cochlear symptoms could be attributed to the different blood supply of the inner ear structures and the different size of the labyrinthine compartments. The cochlea has a blood supply up to four times higher than the vestibular part of the inner ear, whereas the vestibular fluid space is 30% larger. The higher prevalence of symptoms referrable to the less well-perfused vestibular organ provides further evidence that persistent local inert gas supersaturation may cause growth of incoming arterial bubbles and may therefore be an important pathophysiological factor in IEDCS.

  16. Towards new paradigms for the treatment of hypobaric decompression sickness. (United States)

    Dart, T S; Butler, W


    Altitude induced (hypobaric) decompression sickness (DCS) has long been treated with ground level oxygen and U.S. Navy Treatment Tables 5 and 6. These treatment tables originate from surface excursion diving and, when implemented, require significant resource allocation. Although they are effective treatment regimens, these tables were not developed for treating hypobaric DCS which has an etiology similar to saturation diving DCS. In this review, different treatment options for hypobaric DCS are presented. These options include more aggressive use of ground level oxygen and treatment tables using a maximum pressure of 2 atmospheres (ATA). Specific attention is given to USAF Table VIII, an experimental hypobaric DCS treatment-table, and space suit overpressurization treatment. This paradigm shift for DCS treatment is based on a projected increase in hypobaric DCS treatment from exposure to low pressure during several operational conditions: cruise flight in the next generation aircraft (e.g., F-22); high altitude, unpressurized flight by special operations forces; and the extraordinary amount of extravehicular activity (EVA) required to construct the international space station. Anticipating the need to treat DCS encountered during these and other activities, it is proposed that 2 ATA or less hyperbaric oxygen (HBO) treatment conjoined with new collapsible chamber technology can be used to address these issues in a safe and cost effective fashion.

  17. Type II decompression sickness in a hyperbaric inside attendant. (United States)

    Johnson-Arbor, Kelly


    Decompression sickness (DCS) of an inside attendant (IA) is rarely encountered in hyperbarics. This report describes an IA who developed Type II DCS after a routine hyperbaric exposure. A 50-year-old male complained of lower extremity weakness and paresthesias after serving as an IA during a hyperbaric treatment to 40 fsw (122.52 kPa). Within 10 minutes after the conclusion of the treatment, the IA experienced irritability and confusion, and was unable to walk. Physical examination revealed decreased sensation below the T7 level, and decreased strength in the lower extremities. Type II DCS was diagnosed, and the IA was recompressed to 60 fsw (183.78 kPa) on a U.S. Navy Treatment Table 6, which resulted in improvement of his symptoms. Transthoracic echocardiography with bubble study performed 16 months after the event demonstrated a large patent foramen ovale (PFO). Increased age, decreased physical fitness and the undiagnosed PFO may have predisposed this attendant to developing DCS. Although rare, DCS may occur in IAs. Routine monitoring and reporting of the long-term health of hyperbaric IAs should be considered by hyperbaric facilities and medical directors in order to further understand the characteristics of DCS and other hyperbaric-related conditions in these workers.

  18. Exploiting Aerobic Fitness to Reduce Risk of Hypobaric Decompression Sickness (United States)

    Conkin, J.; Gernhardt, M. L.; Wessel, J. H.


    Decompression sickness (DCS) is multivariable. But we hypothesize an aerobically fit person is less likely to experience hypobaric DCS than an unfit person given that fitness is exploited as part of the denitrogenation (prebreathe, PB) process prior to an altitude exposure. Aerobic fitness is peak oxygen uptake (VO2pk, ml/kg/min). Treadmill or cycle protocols were used over 15 years to determine VO2pks. We evaluated dichotomous DCS outcome and venous gas emboli (VGE) outcome detected in the pulmonary artery with Doppler ultrasound associated with VO2pk for two classes of experiments: 1) those with no PB or PB under resting conditions prior to ascent in an altitude chamber, and 2) PB that included exercise for some part of the PB. There were 165 exposures (mean VO2pk 40.5 plus or minus 7.6 SD) with 25 cases of DCS in the first protocol class and 172 exposures (mean VO2pk 41.4 plus or minus 7.2 SD) with 25 cases of DCS in the second. Similar incidence of the DCS (15.2% vs. 14.5%) and VGE (45.5% vs. 44.8%) between the two classes indicates that decompression stress was similar. The strength of association between outcome and VO2pk was evaluated using univariate logistic regression. An inverse relationship between the DCS outcome and VO2pk was evident, but the relationship was strongest when exercise was done as part of the PB (exercise PB, coef. = -0.058, p = 0.07; rest or no PB, coef. = -0.005, p = 0.86). There was no relationship between VGE outcome and VO2pk (exercise PB, coef. = -0.003, p = 0.89; rest or no PB, coef. = 0.014, p = 0.50). A significant change in probability of DCS was associated with fitness only when exercise was included in the denitrogenation process. We believe a fit person that exercises during PB efficiently eliminates dissolved nitrogen from tissues.

  19. Association of microparticles and neutrophil activation with decompression sickness. (United States)

    Thom, Stephen R; Bennett, Michael; Banham, Neil D; Chin, Walter; Blake, Denise F; Rosen, Anders; Pollock, Neal W; Madden, Dennis; Barak, Otto; Marroni, Alessandro; Balestra, Costantino; Germonpre, Peter; Pieri, Massimo; Cialoni, Danilo; Le, Phi-Nga Jeannie; Logue, Christopher; Lambert, David; Hardy, Kevin R; Sward, Douglas; Yang, Ming; Bhopale, Veena B; Dujic, Zeljko


    Decompression sickness (DCS) is a systemic disorder, assumed due to gas bubbles, but additional factors are likely to play a role. Circulating microparticles (MPs)--vesicular structures with diameters of 0.1-1.0 μm--have been implicated, but data in human divers have been lacking. We hypothesized that the number of blood-borne, Annexin V-positive MPs and neutrophil activation, assessed as surface MPO staining, would differ between self-contained underwater breathing-apparatus divers suffering from DCS vs. asymptomatic divers. Blood was analyzed from 280 divers who had been exposed to maximum depths from 7 to 105 meters; 185 were control/asymptomatic divers, and 90 were diagnosed with DCS. Elevations of MPs and neutrophil activation occurred in all divers but normalized within 24 h in those who were asymptomatic. MPs, bearing the following proteins: CD66b, CD41, CD31, CD142, CD235, and von Willebrand factor, were between 2.4- and 11.7-fold higher in blood from divers with DCS vs. asymptomatic divers, matched for time of sample acquisition, maximum diving depth, and breathing gas. Multiple logistic regression analysis documented significant associations (P < 0.001) between DCS and MPs and for neutrophil MPO staining. Effect estimates were not altered by gender, body mass index, use of nonsteroidal anti-inflammatory agents, or emergency oxygen treatment and were modestly influenced by divers' age, choice of breathing gas during diving, maximum diving depth, and whether repetitive diving had been performed. There were no significant associations between DCS and number of MPs without surface proteins listed above. We conclude that MP production and neutrophil activation exhibit strong associations with DCS. Copyright © 2015 the American Physiological Society.

  20. Probabilistic Assessment of Hypobaric Decompression Sickness Treatment Success (United States)

    Conkin, Johnny; Abercromby, Andrew F. J.; Dervay, Joseph P.; Feiveson, Alan H.; Gernhardt, Michael L.; Norcross, Jason R.; Ploutz-Snyder, Robert; Wessel, James H., III


    The Hypobaric Decompression Sickness (DCS) Treatment Model links a decrease in computed bubble volume from increased pressure (DeltaP), increased oxygen (O2) partial pressure, and passage of time during treatment to the probability of symptom resolution [P(symptom resolution)]. The decrease in offending volume is realized in 2 stages: a) during compression via Boyle's Law and b) during subsequent dissolution of the gas phase via the O2 window. We established an empirical model for the P(symptom resolution) while accounting for multiple symptoms within subjects. The data consisted of 154 cases of hypobaric DCS symptoms along with ancillary information from tests on 56 men and 18 women. Our best estimated model is P(symptom resolution) = 1 / (1+exp(-(ln(Delta P) - 1.510 + 0.795×AMB - 0.00308×Ts) / 0.478)), where (DeltaP) is pressure difference (psid), AMB = 1 if ambulation took place during part of the altitude exposure, otherwise AMB = 0; and where Ts is the elapsed time in mins from start of the altitude exposure to recognition of a DCS symptom. To apply this model in future scenarios, values of DeltaP as inputs to the model would be calculated from the Tissue Bubble Dynamics Model based on the effective treatment pressure: (DeltaP) = P2 - P1 | = P1×V1/V2 - P1, where V1 is the computed volume of a spherical bubble in a unit volume of tissue at low pressure P1 and V2 is computed volume after a change to a higher pressure P2. If 100% ground level O2 (GLO) was breathed in place of air, then V2 continues to decrease through time at P2 at a faster rate. This calculated value of (DeltaP then represents the effective treatment pressure at any point in time. Simulation of a "pain-only" symptom at 203 min into an ambulatory extravehicular activity (EVA) at 4.3 psia on Mars resulted in a P(symptom resolution) of 0.49 (0.36 to 0.62 95% confidence intervals) on immediate return to 8.2 psia in the Multi-Mission Space Exploration Vehicle. The P(symptom resolution) increased

  1. Decompression sickness in a vegetarian diver: are vegetarian divers at risk? A case report

    NARCIS (Netherlands)

    van Hulst, Robert A.; van der Kamp, Wim


    We present a case of a diver who suffered decompression sickness (DCS), but who also was a strict vegetarian for more than 10 years. He presented with symptoms of tingling of both feet and left hand, weakness in both legs and sensory deficits for vibration and propriocepsis after two deep dives with

  2. Computed chest tomography in an animal model for decompression sickness: radiologic, physiologic, and pathologic findings

    International Nuclear Information System (INIS)

    Reuter, M.; Struck, N.; Heller, M.; Tetzlaff, K.; Brasch, F.; Mueller, K.M.; Gerriets, T.; Weiher, M.; Hansen, J.; Hirt, S.


    This study was conducted to investigate the early pulmonary effects of acute decompression in an animal model for human decompression sickness by CT and light microscopy. Ten test pigs were exposed to severe decompression stress in a chamber dive. Three pigs were kept at ambient pressure to serve as controls. Decompression stress was monitored by measurement of pulmonary artery pressure and arterial and venous Doppler recording of bubbles of inert gas. Chest CT was performed pre- and postdive and in addition the inflated lungs were examined after resection. Each lung was investigated by light microscopy. Hemodynamic data and bubble recordings reflected severe decompression stress in the ten test pigs. Computed tomography revealed large quantities of ectopic gas, predominantly intravascular, in three of ten pigs. These findings corresponded to maximum bubble counts in the Doppler study. The remaining test pigs showed lower bubble grades and no ectopic gas by CT. Sporadic interstitial edema was demonstrated in all animals - both test and control pigs - by CT of resected lungs and on histologic examination. A severe compression-decompression schedule can liberate large volumes of inert gas which are detectable by CT. Despite this severe decompression stress, which led to venous microembolism, CT and light microscopy did not demonstrate changes in lung structure related to the experimental dive. Increased extravascular lung water found in all animals may be due to infusion therapy. (orig.)

  3. Severe capillary leak syndrome after inner ear decompression sickness in a recreational scuba diver. (United States)

    Gempp, Emmanuel; Lacroix, Guillaume; Cournac, Jean-Marie; Louge, Pierre


    Post-decompression shock with plasma volume deficit is a very rare event that has been observed under extreme conditions of hypobaric and hyperbaric exposure in aviators and professional divers. We report a case of severe hypovolemic shock due to extravasation of plasma in a recreational scuba diver presenting with inner ear decompression sickness. Impaired endothelial function can lead to capillary leak with hemoconcentration and hypotension in severe cases. This report suggests that decompression-induced circulating bubbles may have triggered the endothelial damage, activating the classic inflammatory pathway of increased vascular permeability. This observation highlights the need for an accurate diagnosis of this potentially life-threatening condition at the initial presentation in the Emergency Department after a diving-related injury. An elevated hematocrit in a diver should raise the suspicion for the potential development of capillary leak syndrome requiring specific treatment using albumin infusion as primary fluid replacement. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Documentation for the USAF School of Aerospace Medicine Altitude Decompression Sickness Research Database (United States)


    identification during some database operations and that "t" and other such identifiers are dropped in the following headings to allow easier reading of the...chamber floor, the subject cranks at 24 rpm with 20-Watt resistance as read on the 50 rpm ergometer scale, switching hands each 2 pedal revolutions...Emboli DCS Decompression Sickness EKG /ECG Electrokardiograph (German), electrocardiograph (English) EVA Extravehicular Activity ICD Informed Consent

  5. Redistribution of Decompression Stop Time from Shallow to Deep Stops Increases Incidence of Decompression Sickness in Air Decompression Dives (United States)


    year old active duty male diver surfaced from a 170/30 air dive at <corr>12:11<corr> on 24AUG06 using MK 20 FFM and following the A-2 “deep stops...effort, and this episode responded immediately to pressure. AGE is unlikely due to the experience of the diver, the MK 20 FFM characteristics, and...from a 170/30 air dive at <corr>12:11<corr> on 24AUG06 using MK 20 FFM and following the A-2 “deep stops” experimental decompression profile

  6. Iso-risk air no decompression limits after scoring marginal decompression sickness cases as non-events. (United States)

    Murphy, F Gregory; Swingler, Ashleigh J; Gerth, Wayne A; Howle, Laurens E


    Decompression sickness (DCS) in humans is associated with reductions in ambient pressure that occur during diving, aviation, or certain manned spaceflight operations. Its signs and symptoms can include, but are not limited to, joint pain, radiating abdominal pain, paresthesia, dyspnea, general malaise, cognitive dysfunction, cardiopulmonary dysfunction, and death. Probabilistic models of DCS allow the probability of DCS incidence and time of occurrence during or after a given hyperbaric or hypobaric exposure to be predicted based on how the gas contents or gas bubble volumes vary in hypothetical tissue compartments during the exposure. These models are calibrated using data containing the pressure and respired gas histories of actual exposures, some of which resulted in DCS, some of which did not, and others in which the diagnosis of DCS was not clear. The latter are referred to as marginal DCS cases. In earlier works, a marginal DCS event was typically weighted as 0.1, with a full DCS event being weighted as 1.0, and a non-event being weighted as 0.0. Recent work has shown that marginal DCS events should be weighted as 0.0 when calibrating gas content models. We confirm this indication in the present work by showing that such models have improved performance when calibrated to data with marginal DCS events coded as non-events. Further, we investigate the ramifications of derating marginal events on model-prescribed air diving no-stop limits. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Propranolol Effects on Decompression Sickness in a Simulated DISSUB Rescue in Swine. (United States)

    Forbes, Angela S; Regis, David P; Hall, Aaron A; Mahon, Richard T; Cronin, William A


    Disabled submarine (DISSUB) survivors may face elevated CO2 levels and inert gas saturation, putting them at risk for CO2 toxicity and decompression sickness (DCS). Propranolol was shown to reduce CO2 production in an experimental DISSUB model in humans but its effects on DCS in a DISSUB rescue scenario are unknown. A 100% oxygen prebreathe (OPB) reduces DCS incidence and severity and is incorporated into some DISSUB rescue protocols. We used a swine model of DISSUB rescue to study the effect of propranolol on DCS incidence and mortality with and without an OPB. In Experiment 1, male Yorkshire Swine (70 kg) were pressurized to 2.8 ATA for 22 h. Propranolol 1.0 mg · kg-1 (IV) was administered at 21.25 h. At 22 h, the animal was rapidly decompressed and observed for DCS type, onset time, and mortality. Experimental animals (N = 21; 69 ± 4.1 kg), PROP1.0, were compared to PROP1.0-OPB45 (N = 8; 69 ± 2.8 kg) with the same dive profile, except for a 45 min OPB prior to decompression. In Experiment 2, the same methodology was used with the following changes: swine pressurized to 2.8 ATA for 28 h; experimental group (N = 25; 67 ± 3.3 kg), PROP0.5 bis, propranolol 0.5 mg · kg-1 bis (twice) (IV) was administered at 22 h and 26 h. Control animals (N = 25; 67 ± 3.9 kg) received normal saline. OPB reduced mortality in PROP1.0-OBP45 compared to PROP1.0 (0% vs. 71%). PROP0.5 bis had increased mortality compared to CONTROL (60-% vs. 4%). Administration of beta blockers prior to saturation decompression appears to increase DCS and worsen mortality in a swine model; however, their effects in bounce diving remain unknown.Forbes AS, Regis DP, HallAA, Mahon RT, Cronin WA. Propranolol effects on decompression sickness in a simulated DISSUB rescue in swine. Aerosp Med Hum Perform. 2017; 88(4):385-391.

  8. Perfluorocarbon in Delayed Recompression with a Mixed Gender Swine Model of Decompression Sickness. (United States)

    Cronin, William A; Hall, Aaron A; Auker, Charles R; Mahon, Richard T


    Perfluorocarbons (PFC) are fluorinated hydrocarbons that dissolve gases to a much greater degree than plasma and hold promise in treating decompression sickness (DCS). The efficacy of PFC in a mixed gender model of DCS and safety in recompression therapy has not been previously explored. Swine (25 kg; N = 104; 51 male and 53 female) were randomized into normal saline solution (NSS) or PFC emulsion treatment groups and subjected to compression on air in a hyperbaric chamber at 200 fsw for 31 min. Then the animals were decompressed and observed for signs of DCS. Afterwards, they were treated with oxygen and either PFC (4 cc · kg-1) or NSS (4 cc · kg-1). Surviving animals were observed for 4 h, at which time they underwent recompression therapy using a standard Navy Treatment Table 6. After 24 h the animals were assessed and then euthanized. Survival rates were not significantly different between NSS (74.04%) and PFC (66.67%) treatment groups. All swine that received recompression treatment survived to the end of the study and no seizures were observed in either PFC or NSS animals. Within the saline treated swine group there were no significant differences in DCS survival between male (75.00%, N = 24) and female (73.08%, N = 26) swine. Within the PFC treated swine, survival of females (51.85%, N = 27) was significantly lower than males (81.48%, N = 27). In this large animal mixed gender efficacy study in DCS, PFC did not improve mortality or spinal cord injury, but appears safe during recompressive therapy. Gender differences in DCS treatment with PFC will need further study.Cronin WA, Hall AA, Auker CR, Mahon RT. Perfluorocarbon in delayed recompression with a mixed gender swine model of decompression sickness. Aerosp Med Hum Perform. 2018; 89(1):14-18.

  9. [Research on the incidence of decompression sickness in compressed air works. The development of its recent five years' study]. (United States)

    Mano, Y; Shibayama, M; Matsui, Y


    Compressed air works have been used as the safest construction work for the basic underground or underwater compressed shield or caisson works in Japan; however, the workers who were exposed to the compressed fields must have put themselves at risk of decompression sickness. Decompression sickness is generally considered to be due to the bubble effects and the bubbles originate from the supersaturated gas dissolved in the blood and other tissues. The standard decompression schedule by the Ministry of Labor has been practically applied at the end of compressed air works, and the laborers decompress slowly from the bottom pressure to the surface according to the schedule. It is difficult to completely prevent the sickness and the average percentage of contracting "bends," using the Japanese standard decompression schedule, is considered to be 0.54%. But previous papers reported higher incidences from 1.42 to 3.3% or more. We have continued an actual investigation on the incidence, and the number of the exposed trials amounted to nearly a hundred thousand. These data were compared between recent five years' group and before. Eventually, it was ascertained that the incidence has been significantly decreased in the recent five years; however, greater care in occupational safety control is still needed.

  10. Postural stability in patients with decompression sickness evaluated by means of Quantitative Romberg testing

    DEFF Research Database (Denmark)

    Hedetoft, Morten; Hyldegaard, Ole


    obtained with the Quantitative Romberg test were observed in the group of DCS with vertigo relative to DCS without vertigo and healthy controls. A stepwise improvement in postural instability for DCS patients with vertigo was found following HBO2 therapy. After three treatments of HBO2, postural stability...... was found to be within the normal range of healthy controls. CONCLUSIONS: The Quantitative Romberg test offers the the clinician a fast, reliable and objective set of parametrical data to document postural instability in patients with either confirmed or suspected DCS.......OBJECTIVE: The present study was designed to retrospectively evaluate the use of quantitative Romberg's testing on postural stability during the course of hyperbaric oxygen (HBO2) therapy in patients presenting with decompression sickness (DCS). METHODS: The Quantitative Romberg test was used...

  11. Magnetic Resonance Imaging in Breath-Hold Divers with Cerebral Decompression Sickness

    Directory of Open Access Journals (Sweden)

    Ryu Matsuo


    Full Text Available The mechanism of cerebral decompression sickness (DCS is still unclear. We report 2 cases of breath-hold divers with cerebral DCS in whom magnetic resonance imaging (MRI demonstrated distinctive characteristics. One case presented right hemiparesthesia, diplopia, and gait disturbance after breath-hold diving into the sea at a depth of 20 m. Brain MRI with fluid-attenuated inversion recovery (FLAIR sequence revealed multiple hyperintense lesions in the right frontal lobe, bilateral thalamus, pons, and right cerebellar hemisphere. The second case presented visual and gait disturbance after repetitive breath-hold diving into the sea. FLAIR imaging showed hyperintense areas in the bilateral occipito-parietal lobes. In both cases, diffusion-weighted imaging and apparent diffusion coefficient mapping revealed hyperintense areas in the lesions identified by FLAIR. Moreover, follow-up MRI showed attenuation of the FLAIR signal abnormalities. These findings are suggestive of transient hyperpermeability in the microvasculature as a possible cause of cerebral DCS.

  12. Latent Presentation of Decompression Sickness After Altitude Chamber Training in an Active Duty Flier. (United States)

    Gentry, James; Rango, Juan; Zhang, Jianzhong; Biedermann, Shane


    Decompression sickness (DCS) is a potential danger and risk for both divers and aircrew alike. DCS is also a potential side effect of altitude (hypobaric) chamber training as well and can present long after training occurs. Literature review shows that altitude chamber induced DCS has approximately a 0.25% incidence. A 32-yr-old, active duty military member developed symptoms of DCS 3 h after his hypobaric chamber training. Unfortunately, he did not seek treatment for DCS until 48 h after the exposure. His initial treatment included ground level oxygen therapy for 30 min at 12 L of oxygen per minute using a nonrebreathing mask. He achieved complete symptom resolution and was returned to duty. However, 12 d after his initial Flight Medicine evaluation, the patient returned complaining of a right temporal headache, multijoint pains, and fatigue. He was treated in the hyperbaric chamber and had complete resolution of symptoms. He was returned to flying status and 5 mo later denied any return of symptoms. Hypobaric chamber familiarity training is a requirement for all military aircrew personnel to allow them assess their ability to identify symptoms of hypoxia. This training method is not only costly to maintain, but it also places aircrew and chamber technicians at risk for potential long-term side effects from failed recompression treatment of DCS. We are presenting a case of recurrent DCS symptoms 12 d after initial ground level oxygen therapy.Gentry J, Rango J, Zhang J, Biedermann S. Latent presentation of decompression sickness after altitude chamber training in an active duty flier. Aerosp Med Hum Perform. 2017; 88(4):427-430.

  13. Angiotensin Converting Enzyme Inhibitor Has a Protective Effect on Decompression Sickness in Rats

    Directory of Open Access Journals (Sweden)

    Aleksandra Mazur


    Full Text Available Introduction: Commercial divers, high altitude pilots, and astronauts are exposed to some inherent risk of decompression sickness (DCS, though the mechanisms that trigger are still unclear. It has been previously showed that diving may induce increased levels of serum angiotensin converting enzyme. The renin angiotensin aldosterone system (RAAS is one of the most important regulators of blood pressure and fluid volume. The purpose of the present study was to control the influence of angiotensin II on the appearance of DCS.Methods: Sprague Dawley rats have been pre-treated with inhibitor of angiotensin II receptor type 1 (losartan; 10 mg/kg, angiotensin-converting enzyme (ACE inhibitor (enalapril; 10 mg/kg, and calcium-entry blocker (nifedipine; 20 mg/kg. The experimental groups were treated for 4 weeks before exposure to hyperbaric pressure while controls were not treated. Seventy-five rats were subjected to a simulated dive at 1000 kPa absolute pressure for 45 min before starting decompression. Clinical assessment took place over a period of 60 min after surfacing. Blood samples were collected for measurements of TBARS, interleukin 6 (IL-6, angiotensin II (ANG II and ACE.Results: The diving protocol induced 60% DCS in non-treated animals. This ratio was significantly decreased after treatment with enalapril, but not other vasoactive drugs. Enalapril did not change ANG II or ACE concentration, while losartant decreased post dive level of ACE but not ANG II. None of the treatment modified the effect of diving on TBARS and IL-6 values.Conclusion: Results suggests that the rennin angiotensin system is involved in a process of triggering DCS but this has to be further investigated. However, a vasorelaxation mediated process, which potentially could increase the load of inert gas during hyperbaric exposure, and antioxidant properties were excluded by our results.

  14. A review of the influence of physical condition parameters on a typical aerospace stress effect: Decompression sickness (United States)

    West, V. R.; Parker, J. F., Jr.


    The study examines data on episodes of decompression sickness, particularly from recent Navy work in which the event occurred under multiple stress conditions, to determine the extent to which decompression sickness might be predicted on the basis of personal characteristics such as age, weight, and physical condition. Such information should ultimately be useful for establishing medical selection criteria to screen individuals prior to participation inactivities involving extensive changes in ambient pressure, including those encountered in space operations. The main conclusions were as follows. There is a definite and positive relationship between increasing age and weight and the likelihood of decompression sickness. However, for predictive purposes, the relationship is low. To reduce the risk of bends, particularly for older individuals, strenuous exercise should be avoided immediately after ambient pressure changes. Temperatures should be kept at the low end of the comfort zone. For space activities, pressure changes of over 6-7 psi should be avoided. Prospective participants in future missions such as the Space Shuttle should not be excluded on the basis of age, certainly to age 60, if their general condition is reasonably good and they are not grossly obese. (Modified author abstract)

  15. Decompression sickness rates for chamber personnel: case series from one facility. (United States)

    Brandt, Megan S; Morrison, Thomas O; Butler, William P


    During 2004, a case series of decompression sickness (DCS) meeting the definition of epidemic DCS was observed in the Shaw AFB Physiological Training Program. There were 10 cases of chamber-induced altitude DCS observed. Internal and external investigations focused on time, place, person, and environment. No temporal trend was observed. Chamber, masks, regulators, crew positions, and oxygen sources revealed no defects. Among the cases, mean age was 27 yr. Peak altitude in four cases was 35,000 ft and in the other six cases was 25,000 ft. Six had joint pain, one skin symptoms, and three neurological findings. Four were treated with 100% ground-level oxygen and six with hyperbaric oxygen. Four were students and six were inside observers (IO). Four were women and six men. In the IO, where four of the six were women, no gender effect was seen. Examining the IO monthly exposure load (exposures per month) against DCS suggested a dose-response relationship. This relationship held true when 4 yr of Shaw AFB IO data was studied. Indeed, Poisson regression analysis demonstrated a statistically significant 2.1-fold rise in DCS risk with each monthly exposure. Consequently, the number of exposures per month may need to be considered when devising IO schedules.

  16. A case-control study evaluating relative risk factors for decompression sickness: a research report. (United States)

    Suzuki, Naoko; Yagishita, Kazuyosi; Togawa, Seiichiro; Okazaki, Fumihiro; Shibayama, Masaharu; Yamamoto, Kazuo; Mano, Yoshihiro


    Factors contributing to the pathogenesis of decompression sickness (DCS) in divers have been described in many studies. However, relative importance of these factors has not been reported. In this case-control study, we compared the diving profiles of divers experiencing DCS with those of a control group. The DCS group comprised 35 recreational scuba divers who were diagnosed by physicians as having DCS. The control group consisted of 324 apparently healthy recreational divers. All divers conducted their dives from 2009 to 2011. The questionnaire consisted of 33 items about an individual's diving profile, physical condition and activities before, during and just after the dive. To simplify dive parameters, the dive site was limited to Izu Osezaki. Odds ratios and multiple logistic regression were used for the analysis. Odds ratios revealed several items as dive and health factors associated with DCS. The major items were as follows: shortness of breath after heavy exercise during the dive (OR = 12.12), dehydration (OR = 10.63), and maximum dive depth > 30 msw (OR = 7.18). Results of logistic regression were similar to those by odds ratio analysis. We assessed the relative weights of the surveyed dive and health factors associated with DCS. Because results of several factors conflict with previous studies, future studies are needed.

  17. Delayed treatment of decompression sickness with short, no-air-break tables: review of 140 cases. (United States)

    Cianci, Paul; Slade, John B


    Most cases of decompression sickness (DCS) in the U.S. are treated with hyperbaric oxygen using U.S. Navy Treatment Tables 5 and 6, although detailed analysis shows that those tables were based on limited data. We reviewed the development of these protocols and offer an alternative treatment table more suitable for monoplace chambers that has proven effective in the treatment of DCS in patients presenting to our facility. We reviewed the outcomes for 140 cases of DCS in civilian divers treated with the shorter tables at our facility from January 1983 through December 2002. Onset of symptoms averaged 9.3 h after surfacing. At presentation, 44% of the patients demonstrated mental aberration. The average delay from onset of symptoms to treatment was 93.5 h; median delay was 48 h. Complete recovery in the total group of 140 patients was 87%. When 30 patients with low probability of DCS were excluded, the recovery rate was 98%. All patients with cerebral symptoms recovered. Patients with the highest severity scores showed a high rate of complete recovery (97.5%). Short oxygen treatment tables as originally described by Hart are effective in the treatment of DCS, even with long delays to definitive recompression that often occur among civilian divers presenting to a major Divers Alert Network referral center.

  18. Benefits of hyperbaric oxygen pretreatment for decompression sickness in Bama pigs. (United States)

    Qing, Long; Yi, Hong-Jie; Wang, Ye-Wei; Zhou, Quan; Ariyadewa, Dinesh K; Xu, Wei-Gang


    Decompression sickness (DCS) occurs when ambient pressure is severely reduced during diving and aviation. Hyperbaric oxygen (HBO) pretreatment has been shown to exert beneficial effects on DCS in rats via heat-shock proteins (HSPs). We hypothesized that HBO pretreatment will also reduce DCS via HSPs in swine models. In the first part of our investigation, six swine were subjected to a session of HBO treatment. HSP32, 60, 70 and 90 were detected, before and at 6, 12, 18, 24 and 30 h following exposure in lymphocytes. In the second part of our investigation, another 10 swine were randomly assigned into two groups (five per group). All swine were subjected to two simulated air dives in a hyperbaric chamber with an interval of 7 days. Eighteen hours before each dive, the swine were pretreated with HBO or air: the first group received air pretreatment prior to the first dive and HBO pretreatment prior to the second; the second group were pretreated with HBO first and then air. Bubble loads, skin lesions, inflammation and endothelial markers were detected after each dive. In lymphocytes, all HSPs increased significantly ( P <0.05), with the greatest expression appearing at 18 h for HSP32 and 70. HBO pretreatment significantly reduced all the determined changes compared with air pretreatment. The results demonstrate that a single exposure to HBO 18 h prior to diving effectively protects against DCS in the swine model, possibly via induction of HSPs. © 2018. Published by The Company of Biologists Ltd.

  19. Pulmonary decompression sickness at altitude: early symptoms and circulating gas emboli (United States)

    Balldin, Ulf I.; Pilmanis, Andrew A.; Webb, James T.


    INTRODUCTION: Pulmonary altitude decompression sickness (DCS) is a rare condition. 'Chokes' which are characterized by the triad of substernal pain, cough, and dyspnea, are considered to be associated with severe accumulation of gas bubbles in the pulmonary capillaries and may rapidly develop into a life-threatening medical emergency. This study was aimed at characterizing early symptomatology and the appearance of venous gas emboli (VGE). METHODS: Symptoms of simulated-altitude DCS and VGE (with echo-imaging ultrasound) were analyzed in 468 subjects who participated in 22 high altitude hypobaric chamber research protocols from 1983 to 2001 at Brooks Air Force Base, TX. RESULTS: Of 2525 subject-exposures to simulated altitude, 1030 (41%) had symptoms of DCS. Only 29 of those included DCS-related pulmonary symptoms. Of these, only 3 subjects had all three pulmonary symptoms of chokes; 9 subjects had two of the pulmonary symptoms; and 17 subjects had only one. Of the 29 subject-exposures with pulmonary symptoms, 27 had VGE and 21 had severe VGE. The mean onset times of VGE and symptoms in the 29 subject-exposures were 42 +/- 30 min and 109 +/- 61 min, respectively. In 15 subjects, the symptoms disappeared during recompression to ground level followed by 2 h of oxygen breathing. In the remaining 14 cases, the symptoms disappeared with immediate hyperbaric oxygen treatment. CONCLUSIONS: Pulmonary altitude DCS or chokes is confirmed to be a rare condition. Our data showed that when diagnosed early, recompression to ground level pressure and/or hyperbaric oxygen treatment was 100% successful in resolving the symptoms.

  20. Central nervous system decompression sickness and venous gas emboli in hypobaric conditions. (United States)

    Balldin, Ulf I; Pilmanis, Andrew A; Webb, James T


    Altitude decompression sickness (DCS) that involves the central nervous system (CNS) is a rare but potentially serious condition. Identification of early symptoms and signs of this condition might improve treatment. We studied data from 26 protocols carried out in our laboratory over the period 1983-2003; all were designed to provoke DCS in a substantial proportion of subjects. The data set included 2843 cases. We classified subject-exposures that resulted in DCS as: 1) neurological DCS of peripheral and/or central origin (NEURO); 2) a subset of those that involved only the CNS (CNS); and 3) all other cases, i.e., DCS cases that did not have a neurological component (OTHER). For each case, echo imaging data were used to document whether venous gas emboli (VGE) were present, and their level was classified as: 1) any level, i.e., Grade 1 or higher (VGE-1); and 2) high level, Grade 4 (VGE-4). There were 1108 cases of altitude DCS in the database; 218 were classified as NEURO and 49 of those as CNS. VGE-1 were recorded in 83.8% of OTHER compared with 58.7% of NEURO and 55.1% of CNS (both p Hyperbaric oxygen (HBO) was used to treat about half of the CNS cases, while all other cases were treated with 2 h breathing 100% oxygen at ground level. Since only about half of the rare cases of hypobaric CNS DCS cases were accompanied by any level of VGE, echo imaging for bubbles may have limited application for use as a predictor of such cases.

  1. Effect of oxygen breathing and perfluorocarbon emulsion treatment on air bubbles in adipose tissue during decompression sickness

    DEFF Research Database (Denmark)

    Randsoe, T; Hyldegaard, O


    Decompression sickness (DCS) after air diving has been treated with success by means of combined normobaric oxygen breathing and intravascular perfluorocarbon (PFC) emulsions causing increased survival rate and faster bubble clearance from the intravascular compartment. The beneficial PFC effect...... has been explained by the increased transport capacity of oxygen and inert gases in blood. However, previous reports have shown that extravascular bubbles in lipid tissue of rats suffering from DCS will initially grow during oxygen breathing at normobaric conditions. We hypothesize that the combined...... effect of normobaric oxygen breathing and intravascular PFC infusion could lead to either enhanced extravascular bubble growth on decompression due to the increased oxygen supply, or that PFC infusion could lead to faster bubble elimination due to the increased solubility and transport capacity in blood...

  2. Fluoxetine protection in decompression sickness in mice is enhanced by blocking TREK-1 potassium channel with the spadin antidepressant.

    Directory of Open Access Journals (Sweden)

    Nicolas eVallée


    Full Text Available In mice, disseminated coagulation, inflammation and ischemia induce neurological damages that can lead to the death. These symptoms result from circulating bubbles generated by a pathogenic decompression. An acute fluoxetine treatment or the presence of the TREK-1 potassium channel increased the survival rate when mice are subjected to an experimental dive/decompression protocol. This is a paradox because fluoxetine is a blocker of TREK-1 channels. First, we studied the effects of an acute dose of fluoxetine (50mg/kg in wild-type (WT and TREK-1 deficient mice (Knockout homozygous KO and heterozygous HET. Then, we combined the same fluoxetine treatment with a five-day treatment by spadin, in order to specifically block TREK-1 activity (KO-like mice. KO and KO-like mice could be regarded as antidepressed models.167 mice (45 WTcont 46 WTflux 30 HETflux and 46 KOflux constituting the flux-pool and 113 supplementary mice (27 KO-like 24 WTflux2 24 KO-likeflux 21 WTcont2 17 WTno dive constituting the spad-pool were included in this study. Only 7% of KO-TREK-1 treated with fluoxetine (KOflux and 4% of mice treated with both spadin and fluoxetine (KO-likeflux died from decompression sickness (DCS symptoms. These values are much lower than those of WT control (62% or KO-like mice (41%. After the decompression protocol, mice showed a significant consumption of their circulating platelets and leukocytes.Spadin antidepressed mice were more likely to declare DCS. Nevertheless, which had both blocked TREK-1 channel and were treated with fluoxetine were better protected against DCS. We conclude that the protective effect of such an acute dose of fluoxetine is enhanced when TREK-1 is inhibited. We confirmed that antidepressed models may have worse DCS outcomes, but a concomitant fluoxetine treatment not only decreases DCS severity but increases the survival rate.

  3. Decoupling of bilayer leaflets under gas supersaturation: nitrogen nanobubbles in a membrane and their implication in decompression sickness (United States)

    Li, Jing; Zhang, Xianren; Cao, Dapeng


    Decompression sickness (also known as diver’s sickness) is a disease that arises from the formation of a bubble inside the body caused by rapid decompression from high atmospheric pressures. However, the nature of pre-existing micronuclei that are proposed for interpreting the formation and growth of the bubble, as well as their very existence, is still highly controversial. In this work, atomistic molecular dynamics simulations are employed to investigate the nucleation of gas bubbles under the condition of nitrogen supersaturation, in the presence of a lipid bilayer and lipid micelle representing other macromolecules with a smaller hydrophobic region. Our simulation results demonstrate that by crossing a small energy barrier, excess nitrogen molecules can enter the lipid bilayer nearly spontaneously, for which the hydrophobic core serves as a potential well for gas enrichment. At a rather low nitrogen supersaturation, gas molecules in the membrane are dispersed in the hydrophobic region of the bilayer, with a slight increase in membrane thickness. But as the level of gas supersaturation reaches a threshold, the accumulation of N2 molecules in the bilayer center causes the two leaflets to be decoupled and the formation of nanobubbles. Therefore, we propose a nucleation mechanism for bubble formation in a supersaturated solution of inert gas: a cell membrane acts as a potential well for gas enrichment, being an ideal location for forming nanobubbles that induce membrane damage at a high level of gas supersaturation. As opposed to previous models, the new mechanism involves forming gas nuclei in a very low-tension hydrophobic environment, and thus a rather low energy barrier is required and pre-existing bubble micronuclei are not needed.

  4. Different effect of l-NAME treatment on susceptibility to decompression sickness in male and female rats. (United States)

    Mazur, Aleksandra; Buzzacott, Peter; Lambrechts, Kate; Wang, Qiong; Belhomme, Marc; Theron, Michael; Popov, Georgi; Distefano, Giovanni; Guerrero, Francois


    Vascular bubble formation results from supersaturation during inadequate decompression contributes to endothelial injuries, which form the basis for the development of decompression sickness (DCS). Risk factors for DCS include increased age, weight-fat mass, decreased maximal oxygen uptake, chronic diseases, dehydration, and nitric oxide (NO) bioavailability. Production of NO is often affected by diving and its expression-activity varies between the genders. Little is known about the influence of sex on the risk of DCS. To study this relationship we used an animal model of Nω-nitro-l-arginine methyl ester (l-NAME) to induce decreased NO production. Male and female rats with diverse ages and weights were divided into 2 groups: treated with l-NAME (in tap water; 0.05 mg·mL(-1) for 7 days) and a control group. To control the distribution of nitrogen among tissues, 2 different compression-decompression protocols were used. Results showed that l-NAME was significantly associated with increased DCS in female rats (p = 0.039) only. Weight was significant for both sexes (p = 0.01). The protocol with the highest estimated tissue pressures in the slower compartments was 2.6 times more likely to produce DCS than the protocol with the highest estimated tissue pressures in faster compartments. The outcome of this study had significantly different susceptibility to DCS after l-NAME treatment between the sexes, while l-NAME per se had no effect on the likelihood of DCS. The analysis also showed that for the appearance of DCS, the most significant factors were type of protocol and weight.

  5. The Pathophysiology of Decompression Sickness and the Effects of Doppler Detectable Bubbles. (United States)


    workers (Harvey, 1951a and 1951b) and Blinks, Twitty and Whiteker (1951) show that muscular activity was a 23 ~I. predisposing factor to the formation of...Hills, 1966), the mechanism of action is somewhat specific (neural distension ); but for those theories utilizing circulation and/or intravascular...highly perfused non- muscular tissue, such as kidney, forms a gas phase following decompression, Doppler perivascular cuff probes were surgically placed on

  6. Effect of metabolic gases and water vapor, perfluorocarbon emulsions, and nitric oxide on tissue bubbles during decompression sickness. (United States)

    Randsøe, Thomas


    In aviation and diving, fast decrease in ambient pressure, such as during accidental loss of cabin pressure or when a diver decompresses too fast to sea level, may cause nitrogen (N2) bubble formation in blood and tissue resulting in decompression sickness (DCS). Conventional treatment of DCS is oxygen (O2) breathing combined with recompression.  However, bubble kinetic models suggest, that metabolic gases, i.e. O2 and carbon dioxide (CO2), and water vapor contribute significantly to DCS bubble volume and growth at hypobaric altitude exposures. Further, perfluorocarbon emulsions (PFC) and nitric oxide (NO) donors have, on an experimental basis, demonstrated therapeutic properties both as treatment and prophylactic intervention against DCS. The effect was ascribed to solubility of respiratory gases in PFC, plausible NO elicited nuclei demise and/or N2 washout through enhanced blood flow rate. Accordingly, by means of monitoring injected bubbles in exposed adipose tissue or measurements of spinal evoked potentials (SEPs) in anaesthetized rats, the aim of this study was to: 1) evaluate the contribution of metabolic gases and water vapor to bubble volume at different barometrical altitude exposures, 2) clarify the O2 contribution and N2 solubility from bubbles during administration of PFC at normo- and hypobaric conditions and, 3) test the effect of different NO donors on SEPs during DCS upon a hyperbaric air dive and, to study the influence of  NO on tissue bubbles at high altitude exposures. The results support the bubble kinetic models and indicate that metabolic gases and water vapor contribute significantly to bubble volume at 25 kPa (~10,376 m above sea level) and constitute a threshold for bubble stabilization or decay at the interval of 47-36 kPa (~6,036 and ~7,920 m above sea level). The effect of the metabolic gases and water vapor seemed to compromise the therapeutic properties of both PFC and NO at altitude, while PFC significantly increased bubble

  7. An Annotated Bibliography of Hypobaric Decompression Sickness Research Conducted at the Crew Technology Division, USAF School of Aerospace Medicine, Brooks AFB, Texas from 1983 to 1988 (United States)


    AN ANNOTATED BIBLIOGRAPHY OF HYPOBARIC DECOMPRESSION SICKNESS RESEARCH CONDUCTED AT THE CREW TECHNOLOGY DIVISION, USAF SCHOOL OF AEROSPACE MEDICINE...190 man-flights to four selected altitudes (30000, 27500, 25000, and 22500 ft pressure equivalent) in a hypobaric chamber. The subjects’ ages ranged...conditions and two of these developed delayed sy~rtcms. Three of these five subjects underwent hyperbaric oxygen treatment. Conclusion. Female subjects

  8. Decompression sickness among diving fishermen in Mexico: observational retrospective analysis of DCS in three sea cucumber fishing seasons. (United States)

    Huchim-Lara, Oswaldo; Chin, Walter; Salas, Silvia; Rivera-Canul, Normando; Cordero-Romero, Salvador; Tec, Juan; Joo, Ellie; Mendez-Dominguez, Nina


    The probabilities of decompression sickness (DCS) among diving fishermen are higher than in any other group of divers. Diving behavior of artisanal fishermen has been directed mainly to target high-value species. The aim of this study was to learn about the occurrence of DCS derived from sea cucumber harvesting in the Yucatán Peninsula, Mexico. We conducted a retrospective chart review of diving fishermen treated at a multiplace hyperbaric chamber in Tizimín, Mexico. In total, 233 recompression therapies were rendered to 166 diving fishermen from 2014 to 2016. The average age was 36.7 ± 9.2 years (range: 20-59 years); 84.3% had experienced at least one DCS event previously. There was a correlation between age and DCS incidents (F: 8.3; R2: 0.07) and differences in the fishing depth between seasons (H: 9.99; p⟨0.05). Musculoskeletal pain was the most frequently reported symptom. Three divers, respectively, suffered permanent hearing loss, spinal cord injury and fatal outcome. Diving fishermen experience DCS at an alarmingly high rate, probably due to the type of species targeted, given the requirements in each case. Understanding divers' behaviors and their incentives while in pursuit of high-value species such as sea cucumber could help to find ways to mitigate health risks and help enforce regulation. Copyright© Undersea and Hyperbaric Medical Society.

  9. Change of occurance of type 1 and type 2 decompression sickness of divers treated at the Croatian Naval Medical Institute in the period from 1967 to 2000. (United States)

    Andrić, Dejan; Petri, Nadan M; Stipancević, Hrvoje; Petri, Lena Vranjković; Kovacević, Hasan


    A significant change of occurrence (p=0.0343) of type 1 and type 2 decompression sickness (DCS) of divers in Croatia was observed in the period from 1991 to 2002 (type 1: n=26, 37.68% and type 2: n=43, 62.32%) compared with the period from 1967 to 1990 (type 1: n=93, 52.84% and type 2: n=83, 47.16%). The change was attributed to the extensive usage of diving computers and artificial gas mixtures which enable extended bottom times and deeper dives, thus putting divers at an increased decompression risk. The importance of the results of this report is in the fact that permanent neurological deficit occurs only after type 2 DCS. Injured divers with permanent loss after type 2 DCS are not fit for diving and require a long term medical care, thus becoming a significant public health problem.

  10. Decompression sickness in breath-hold diving, and its probable connection to the growth and dissolution of small arterial gas emboli. (United States)

    Goldman, Saul; Solano-Altamirano, J M


    We solved the Laplace equation for the radius of an arterial gas embolism (AGE), during and after breath-hold diving. We used a simple three-region diffusion model for the AGE, and applied our results to two types of breath-hold dives: single, very deep competitive-level dives and repetitive shallower breath-hold dives similar to those carried out by indigenous commercial pearl divers in the South Pacific. Because of the effect of surface tension, AGEs tend to dissolve in arterial blood when arteries remote from supersaturated tissue. However if, before fully dissolving, they reach the capillary beds that perfuse the brain and the inner ear, they may become inflated with inert gas that is transferred into them from these contiguous temporarily supersaturated tissues. By using simple kinetic models of cerebral and inner ear tissue, the nitrogen tissue partial pressures during and after the dive(s) were determined. These were used to theoretically calculate AGE growth and dissolution curves for AGEs lodged in capillaries of the brain and inner ear. From these curves it was found that both cerebral and inner ear decompression sickness are expected to occur occasionally in single competitive-level dives. It was also determined from these curves that for the commercial repetitive dives considered, the duration of the surface interval (the time interval separating individual repetitive dives from one another) was a key determinant, as to whether inner ear and/or cerebral decompression sickness arose. Our predictions both for single competitive-level and repetitive commercial breath-hold diving were consistent with what is known about the incidence of cerebral and inner ear decompression sickness in these forms of diving. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. The effectiveness of ground level post-flight 100 percent oxygen breathing as therapy for pain-only altitude Decompression Sickness (DCS) (United States)

    Demboski, John T.; Pilmanis, Andrew A.


    In both the aviation and space environments, decompression sickness (DCS) is an operational limitation. Hyperbaric recompression is the most efficacious treatment for altitude DCS. However, the inherent recompression of descent to ground level while breathing oxygen is in itself therapy for altitude DCS. If pain-only DCS occurs during a hypobaric exposure, and the symptoms resolver during descent, ground level post-flight breathing of 100% O2 for 2 hours (GLO2) is considered sufficient treatment by USAF Regulation 161-21. The effectiveness of the GLO2 treatment protocol is defined.

  12. Thirty-five Day Fluoxetine Treatment Limits Sensory-Motor Deficit and Biochemical Disorders in a Rat Model of Decompression Sickness

    Directory of Open Access Journals (Sweden)

    Caroline Cosnard


    Full Text Available According to the OECD statistical base for 2014, anti-depressants will, on average, be distributed at a rate of 62 daily doses per 1,000 inhabitants for the 25 countries surveyed (Health at a glance: Europe 2014; OECD Health Statistics; World Health Organization and OECD Health Statistics, 2014. Divers must be concerned. On another hand, divers are potentially exposed to decompression sickness including coagulation inflammation and ischemia, which can result in neurological lesions or even death. The purpose of this study is to assess whether chronic treatment with anti-depressants may represent a contraindication to the practice of an at-risk activity, such as, scuba diving, or even presents a benefit by attenuating the severity of the symptoms. We study for the first time the effect of a 35-day fluoxetine treatment (20 mg/kg on the occurrence of decompression sickness in laboratory rats (n = 79. Following exposure to the hazardous protocol, there is a significant correlation between the type of treatment and the clinical status of the rats in favor of a better clinical prognosis for the rats treated with fluoxetine with a significantly higher number of No DCS status and a lower number of Severe DCS status in the Flux, compared to Controls. The treatment modifies the rat performances both significantly and favorably during the physical and behavioral tests, just like their biological and biochemical constants. After decompression, rats under treatment display lower sensory-motor deficit and lowers biochemical disorders. From a biological point of view, we conclude fluoxetine should not be seen as a contraindication for diving on the basis of anticipated increased physiological risk.

  13. The effect of the perfluorocarbon emulsion Oxycyte on platelet count and function in the treatment of decompression sickness in a swine model. (United States)

    Cronin, William A; Senese, Angela L; Arnaud, Francoise G; Regis, David P; Auker, Charles R; Mahon, Richard T


    Decompression from elevated ambient pressure is associated with platelet activation and decreased platelet counts. Standard treatment for decompression sickness (DCS) is hyperbaric oxygen therapy. Intravenous perfluorocarbon (PFC) emulsion is a nonrecompressive therapy being examined that improves mortality in animal models of DCS. However, PFC emulsions are associated with a decreased platelet count. We used a swine model of DCS to study the effect of PFC therapy on platelet count, function, and hemostasis. Castrated male swine (n = 50) were fitted with a vascular port, recovered, randomized, and compressed to 180 feet of sea water (fsw) for 31 min followed by decompression at 30 fsw/min. Animals were observed for DCS, administered 100% oxygen, and treated with either emulsified PFC Oxycyte (DCS-PFC) or isotonic saline (DCS-NS). Controls underwent the same procedures, but were not compressed (Sham-PFC and Sham-NS). Measurements of platelet count, thromboelastometry, and coagulation were obtained 1 h before compression and 1, 24, 48, 96, 168 and 192 h after treatment. No significant changes in normalized platelet counts were observed. Prothrombin time was elevated in DCS-PFC from 48 to 192 h compared with DCS-NS, and from 96 to 192 h compared with Sham-PFC. Normalized activated partial thromboplastin time was also elevated in DCS-PFC from 168 to 192 h compared with Sham-PFC. No bleeding events were noted. DCS treated with PFC (Oxycyte) does not impact platelet numbers, whole blood clotting by thromboelastometry, or clinical bleeding. Late changes in prothrombin time and activated partial thromboplastin time associated with PFC use in both DCS therapy and controls warrant further investigation.

  14. Risk of Decompression Sickness in Shallow No-Stop Air Diving An Analysis of Naval Safety Center Data 1990-1994

    National Research Council Canada - National Science Library

    Flynn, E


    ...) in shallow no-stop air diving using current U.S. Navy no-decompression limits (USN57). Navy and Marine Corp divers performed 163,400 no-decompression dives between 21 and 55 feet of sea water (fsw...

  15. [Decompression sickness accident management in remote areas. Use of immediate in-water recompression therapy. Review and elaboration of a new protocol targeted for a mission at Clipperton atoll]. (United States)

    Blatteau, J-E; Jean, F; Pontier, J-M; Blanche, E; Bompar, J-M; Meaudre, E; Etienne, J-L


    In-Water Recompression (IWR) is defined as a treatment of decompression sickness by immediate underwater recompression after the onset of symptoms in remote areas where hyperbaric chambers are not available. At least three methods of IWR have been published. They used pure oxygen breathing for prolonged periods of time at a depth of 9 m. IWR effectiveness in comparison with standard recompression techniques has not been assessed. IWR should be used in remote localities as an immediate measure to stop the evolution of decompression illness before evacuating the victim for subsequent treatment to the nearest hyperbaric facility. Resulting from environmental conditions, the risks of drowning and hypothermia are the most often quoted, pure oxygen breathing at 9 m can also expose to acute oxygen toxicity. The objectives of this work are: first, to examine existing published methods of IWR; second, to propose a new method of IWR. All published methods of IWR involve victim returning underwater for a long period of time. But dehydration due to a long period of immersion can worsen symptoms of decompression illness and acute oxygen toxicity is also related to the duration of the exposition. In response to these considerations we developed a shorter method of conducting IWR specifically targeted for a diving mission at Clipperton atoll in the Northern Pacific Ocean.

  16. Subatmospheric Decompression Sickness in Man, (United States)


    are described as ecchymotic or petechial but in the cases seen in the ac- tive phase, in none has the skin ever failed to blanch completely under local...are undoubtedly petechial . There has been no convincing evidence of extravasation in compressed air cases (Griffiths, personal communication) or in...recommended that exposure to altitude during the active stage of antibody production, when malaise and low grade fever are common, should be avoided

  17. Decompression illness - critical review

    Directory of Open Access Journals (Sweden)

    C S Mohanty


    Full Text Available Decompression illness is caused by intravascular or extravascular bubbles that are formed as a result of reduction in environmental pressure (decompression. The term covers both arterial gas embolism, in which alveolar gas or venous gas emboli (via cardiac shunts or via pulmonary vessels are introduced into the arterial circulation, and decompression sickness, which is caused by in-situ bubble formation from dissolved inert gas. Both syndromes can occur in divers, compressed air workers, aviators, and astronauts, but arterial gas embolism also arises from iatrogenic causes unrelated to decompression. Risk of decompression illness is affected by immersion, exercise, and heat or cold. Manifestations range from itching and minor pain to neurological symptoms, cardiac collapse, and death. First-aid treatment is 1 0 0 % oxygen and definitive treatment is recompression to increased pressure, breathing 1 0 0 % oxygen. Adjunctive treatment, including fluid administration and prophylaxis against venous thromboembolism in paralysed patients, is also recommended Treatment is, in most cases, effective although residual deficits can remain in serious cases, even after several recompressions.

  18. Decompression Theory. (United States)


    vessel- rich group, a vessel-poor group, a fatty group, and so on ( Papper and Kitz 1963). Behnke’s original suggestion, put forth in the first...An examination of the critical released volume concept in decom- pression sickness. Proc. Roy. Soc. Lond. B. 197:299-313, 1977. Papper , E.M., and R.J

  19. Guide to Altitude Decompression Sickness Research (United States)


    fitness flight gender growth helium hormone human hyperbaric hypobaric hypoxia incidence injury interface interruption intra in-vitro isobaric male...exposure in hypobaric chambers and, due to its omission of other training, was not adequate for any other use. The two items required prior to...were kept in the contractor lab. 3. Hypobaric exposure records (Research Chamber Flight Records, including AF Forms 361) were kept by Altitude and

  20. Car Sickness (United States)

    ... Preventable Diseases Healthy Children > Health Issues > Conditions > Head Neck & Nervous System > Car Sickness Health Issues Listen Español Text Size Email Print Share Car Sickness Page Content ...

  1. Aseptic necrosis in caisson workers: a new set of decompression tables. (United States)

    Downs, G J; Kindwall, E P


    There is a high incidence of aseptic necrosis and decompression sickness among caisson workers due to inadequate decompression using the current OSHA decompression tables (1-7). Because of this, a new set of tables--Autodec III-O2--was developed which more effectively eliminates nitrogen from the body and, therefore, should decrease the incidence of both bends and aseptic necrosis. The Autodec III-O2 schedule's superiority was statistically significant at a level of 0.08 compared to the OSHA table. It is our conclusion that OSHA should adopt the Autodec III-O2 schedule as a replacement for the current decompression tables.

  2. Decompression Mechanisms and Decompression Schedule Calculations. (United States)


    phisiology - The effects of altitude. Handbook of Physiology, Section 3: Respiration, Vol. II. W.O. Fenn and H. Rahn eds. Wash, D.C.; Am. Physiol. Soc. 1 4...decompression studies from other laboratories. METHODS Ten experienced and physically qualified divers ( ages 22-42) were compressed at a rate of 60...STATISTICS* --- ---------------------------------------------------------- EXPERIMENT N AGE (yr) HEIGHT (cm) WEIGHT (Kg) BODY FAT

  3. Cutis marmorata in decompression illness may be cerebrally mediated: a novel hypothesis on the aetiology of cutis marmorata

    NARCIS (Netherlands)

    Kemper, Tom Cpm; Rienks, R.; van Ooij, P. Jam; van Hulst, R. A.


    Cutaneous decompression sickness (DCS) is often considered to be a mild entity that may be explained by either vascular occlusion of skin vessels by bubbles entering the arterial circulation through a right-to-left shunt or bubble formation due to saturated subcutaneous tissue during decompression.

  4. Serum sickness (United States)

    ... the problem should be stopped. Avoid using that medicine or antiserum in the future. ... Call your provider if you received medicine or antiserum in the last 4 weeks and have symptoms of serum sickness.

  5. Morning sickness (United States)

    ... not predict how you will feel in future pregnancies. Causes The exact cause of morning sickness is unknown. It may be caused by hormone changes or lower blood sugar during early pregnancy. Emotional stress, fatigue, traveling, or some foods can ...

  6. Radiation sickness

    International Nuclear Information System (INIS)

    Endoh, Masaru; Ishida, Yusei; Saeki, Mitsuaki


    The frequency of radiation sickness in 1,060 patients treated at our Department was 12.8 percent. It was frequent in patients with brain cancer (12 percent), whole spine cancer (47 percent), uterus cancer (28 percent), lung cancer (22 percent) and esophagus cancer (12 percent). Radiation sickness following X-irradiation was studied in its relation to patient's age, size of radiation fields, dosis and white blood cell count. However, we could not find any definite clinical feature relevant to occurrence. There are many theories published concerning the mechanism of radiation sickness. Clinical experiences have shown that radiation sickness cannot be explained by one theory alone but by several theories such as those based on psychology, stress or histamine. (author)

  7. Evaluation of safety of hypobaric decompressions and EVA from positions of probabilistic theory (United States)

    Nikolaev, V. P.

    Formation and subsequent evolution of gas bubbles in blood and tissues of subjects exposed to decompression are casual processes in their nature. Such character of bubbling processes in a body predetermines probabilistic character of decompression sickness (DCS) incidence in divers, aviators and astronauts. Our original probabilistic theory of decompression safety is based on stochastic models of these processes and on the concept of critical volume of a free gas phase in body tissues. From positions of this theory, the probability of DCS incidence during single-stage decompressions and during hypobaric decompressions under EVA in particular, is defined by the distribution of possible values of nucleation efficiency in "pain" tissues and by its critical significance depended on the parameters of a concrete decompression. In the present study the following is shown: 1) the dimensionless index of critical nucleation efficiency for "pain" body tissues is a more adequate index of decompression stress in comparison with Tissue Ratio, TR; 2) a priory the decompression under EVA performed according to the Russian protocol is more safe than decompression under EVA performed in accordance with the U.S. protocol; 3) the Russian space suit operated at a higher pressure and having a higher "rigidity" induces a stronger inhibition of mechanisms of cavitation and gas bubbles formation in tissues of a subject located in it, and by that provides a more considerable reduction of the DCS risk during real EVA performance.

  8. Bubble formation after a 20-m dive: deep-stop vs. shallow-stop decompression profiles

    NARCIS (Netherlands)

    Schellart, Nico A. M.; Corstius, Jan-Jaap Brandt; Germonpré, Peter; Sterk, Wouter


    OBJECTIVES: It is claimed that performing a "deep stop," a stop at about half of maximal diving depth (MDD), can reduce the amount of detectable precordial bubbles after the dive and may thus diminish the risk of decompression sickness. In order to ascertain whether this reduction is caused by the

  9. Sickness presence, sick leave and adjustment latitude

    Directory of Open Access Journals (Sweden)

    Joachim Gerich


    Full Text Available Objectives: Previous research on the association between adjustment latitude (defined as the opportunity to adjust work efforts in case of illness and sickness absence and sickness presence has produced inconsistent results. In particular, low adjustment latitude has been identified as both a risk factor and a deterrent of sick leave. The present study uses an alternative analytical strategy with the aim of joining these results together. Material and Methods: Using a cross-sectional design, a random sample of employees covered by the Upper Austrian Sickness Fund (N = 930 was analyzed. Logistic and ordinary least square (OLS regression models were used to examine the association between adjustment latitude and days of sickness absence, sickness presence, and an estimator for the individual sickness absence and sickness presence propensity. Results: A high level of adjustment latitude was found to be associated with a reduced number of days of sickness absence and sickness presence, but an elevated propensity for sickness absence. Conclusions: Employees with high adjustment latitude experience fewer days of health complaints associated with lower rates of sick leave and sickness presence compared to those with low adjustment latitude. In case of illness, however, high adjustment latitude is associated with a higher pro­bability of taking sick leave rather than sickness presence.

  10. Studies on the Mechanism and Prevention of Decompression Sickness. (United States)


    for trypan blue extraction from tissues or blood) con- sisted of four volumes of 95% ethanol and one volume of 17% benzalkonium chloride (Zephi- ran...sacrificed (in the striking reduction in mortality and absence or de- the experimental group the animals that did not succumb crease in severity of the...smooth muscle stimulating activity. The nature of the smooth muscle stimulating agent (s) involved has not yet been determined. Partial reduction in the

  11. Air Break During Preoxygenation and Risk of Altitude Decompression Sickness (United States)


    examination and were representative of the USAF rated aircrew popula- tion. They were not allowed to participate in scuba div- ing, hyperbaric exposures, or...subjects dur- ing the hypobaric exposures and the subjects were not questioned about how they felt during the altitude ex- posures. Each subject consult with the physicians in Hyperbaric Medicine within the same building. Endpoints of the exposures were: 1) comple- tion of the scheduled

  12. Effect of oxygen-breathing during a decompression-stop on bubble-induced platelet activation after an open-sea air dive: oxygen-stop decompression. (United States)

    Pontier, J-M; Lambrechts, K


    We highlighted a relationship between decompression-induced bubble formation and platelet micro-particle (PMP) release after a scuba air-dive. It is known that decompression protocol using oxygen-stop accelerates the washout of nitrogen loaded in tissues. The aim was to study the effect of oxygen deco-stop on bubble formation and cell-derived MP release. Healthy experienced divers performed two scuba-air dives to 30 msw for 30 min, one with an air deco-stop and a second with 100% oxygen deco-stop at 3 msw for 9 min. Bubble grades were monitored with ultrasound and converted to the Kisman integrated severity score (KISS). Blood samples for cell-derived micro-particle analysis (AnnexinV for PMP and CD31 for endothelial MP) were taken 1 h before and after each dive. Mean KISS bubble score was significantly lower after the dive with oxygen-decompression stop, compared to the dive with air-decompression stop (4.3 ± 7.3 vs. 32.7 ± 19.9, p air-breathing decompression stop, we observed an increase of the post-dive mean values of PMP (753 ± 245 vs. 381 ± 191 ng/μl, p = 0.003) but no significant change in the oxygen-stop decompression dive (329 ± 215 vs. 381 +/191 ng/μl, p = 0.2). For the post-dive mean values of endothelial MP, there was no significant difference between both the dives. The Oxygen breathing during decompression has a beneficial effect on bubble formation accelerating the washout of nitrogen loaded in tissues. Secondary oxygen-decompression stop could reduce bubble-induced platelet activation and the pro-coagulant activity of PMP release preventing the thrombotic event in the pathogenesis of decompression sickness.

  13. Compressed air tunneling and caisson work decompression procedures: development, problems, and solutions. (United States)

    Kindwall, E P


    Multinational experience over many years indicates that all current air decompression schedules for caisson and compressed air tunnel workers are inadequate. All of them, including the Occupational Safety and Health Administration tables, produce dysbaric osteonecrosis. The problem is compounded because decompression sickness (DCS) tends to be underreported. Permanent damage in the form of central nervous system or brain damage may occur in compressed air tunnel workers, as seen on magnetic resonance imaging, in addition to dysbaric osteonecrosis. Oxygen decompression seems to be the only viable method for safely decompressing tunnel workers. Oxygen decompression of tunnel workers has been successfully used in Germany, France, and Brazil. In Germany, only oxygen decompression of compressed air workers is permitted. In our experience, U.S. Navy tables 5 and 6 usually prove adequate to treat DCS in caisson workers despite extremely long exposure times, allowing patients to return to work following treatment for DCS. Tables based on empirical data and not on mathematical formulas seem to be reasonably safe. U.S. Navy Exceptional Exposure Air Decompression tables are compared with caisson tables from the United States and Great Britain.

  14. Radiation sickness

    International Nuclear Information System (INIS)

    Chin, A.; Leer, J.W.H.; Craandijk, M.; Feenstra, W.F.F.


    In a prospective inventory analysis of 169 irradiated patients concerning the incidence and course of Acute Radiation Sickness (fatigue, loss of appetite, nausea and vomiting), it was found that 2/3 of the patients had these complaints. The complaints started during the first week of treatment and mostly even within a few hours after each radiotherapy session. All complaints were progressive during the radiotherapy course, but disappeared spontaneously within one week after completion of the treatment. The possible occurrence of these symptoms soon after the start of radiotherapy should be kept in mind, especially since they can be reduced by simple retimens. (author). 14 refs.; 2 tabs

  15. [Developing and testing of decompression regimes for caisson operations while constructing Moscow metro]. (United States)

    Rodchenkov, S V; Syrovegin, A V; Shulagin, I A


    Decompression regimes for caisson operations at the pressures up to 5 ata exceeding duration of the regimes specified in the caisson regulations have been developed. The regimes were tested and validated in dry altitude chamber with participation of exercising human subjects. Seventeen test-subjects took part in 54 tests. No symptoms of decompression sickness were documented. Air embolism was observed in 28 +/- 6% of cases at rest and in 72 +/- 6% of cases following provocative leg movements. The air embolism expression tended to increase with exposure to pressure.

  16. [Orbital decompression in Grave's ophtalmopathy]. (United States)

    Longueville, E


    Graves disease orbitopathy is a complex progressive inflammatory disease. Medical treatment remains in all cases the proposed treatment of choice. Surgical treatment by bone decompression can be considered as an emergency mainly in cases of optic neuropathy or ocular hypertension not being controlled medically or in post-traumatic exophthalmos stage. Emergency bone decompression eliminates compression or stretching of the optic nerve allowing visual recovery. The uncontrolled ocular hypertension will benefit from decompression. The normalization of intraocular pressure may be obtained by this surgery or if needed by the use of postoperative antiglaucoma drops or even filtration surgery. In all operated cases, the IOP was normalized with an average decrease of 7.71 mmHg and a cessation of eye drops in 3/7 cases. Regarding sequelae, our therapeutic strategy involves consecutively surgery of the orbit, extraocular muscles and eyelids. The orbital expansion gives excellent results on the cosmetic level and facilitates the implementation of subsequent actions.

  17. Cardiopulmonary Changes with Moderate Decompression in Rats (United States)

    Robinson, R.; Little, T.; Doursout, M.-F.; Butler, B. D.; Chelly, J. E.


    Sprague-Dawley rats were compressed to 616 kPa for 120 min then decompressed at 38 kPa/min to assess the cardiovascular and pulmonary responses to moderate decompression stress. In one series of experiments the rats were chronically instrumented with Doppler ultrasonic probes for simultaneous measurement of blood pressure, cardiac output, heart rate, left and right ventricular wall thickening fraction, and venous bubble detection. Data were collected at base-line, throughout the compression/decompression protocol, and for 120 min post decompression. In a second series of experiments the pulmonary responses to the decompression protocol were evaluated in non-instrumented rats. Analyses included blood gases, pleural and bronchoalveolar lavage (BAL) protein and hemoglobin concentration, pulmonary edema, BAL and lung tissue phospholipids, lung compliance, and cell counts. Venous bubbles were directly observed in 90% of the rats where immediate post-decompression autopsy was performed and in 37% using implanted Doppler monitors. Cardiac output, stroke volume, and right ventricular wall thickening fractions were significantly decreased post decompression, whereas systemic vascular resistance was increased suggesting a decrease in venous return. BAL Hb and total protein levels were increased 0 and 60 min post decompression, pleural and plasma levels were unchanged. BAL white blood cells and neutrophil percentages were increased 0 and 60 min post decompression and pulmonary edema was detected. Venous bubbles produced with moderate decompression profiles give detectable cardiovascular and pulmonary responses in the rat.

  18. Physiotherapy after subacromial decompression surgery

    DEFF Research Database (Denmark)

    Christiansen, David Høyrup; Falla, Deborah; Frost, Poul


    This paper describes the development and details of a standardised physiotherapy exercise intervention designed to address pain and disability in patients with difficulty returning to usual activities after arthroscopic decompression surgery for subacromial impingement syndrome. To develop...... the intervention, the literature was reviewed with respect to the effectiveness of postoperative exercises, components of previous exercise programmes were extracted, and input from clinical physiotherapists in the field was obtained through a series of workshops. The physiotherapy exercise intervention...

  19. Worried sick? Sickness absence during organizational turmoil


    Bratberg, Espen; Monstad, Karin


    Sickness absence has risen over the past years in Norway. An explanation put forward is that a tougher labour market represents a health hazard, while a competing hypothesis predicts that loss of job security works as a disciplinary device. In this analysis we aim to trace a causal impact of organizational turmoil or job insecurity on sickness absence, applying a difference-in-difference approach. Utilizing a negative financial shock that hit specific employers and workplaces, we find that...

  20. Decompression tables for inside chamber attendants working at altitude. (United States)

    Bell, James; Thombs, Paul A; Davison, William J; Weaver, Lindell K


    Hyperbaric oxygen (HBO2) multiplace chamber inside attendants (IAs) are at risk for decompression sickness (DCS). Standard decompression tables are formulated for sea-level use, not for use at altitude. At Presbyterian/St. Luke's Medical Center (Denver, Colorado, 5,924 feet above sea level) and Intermountain Medical Center (Murray, Utah, 4,500 feet), the decompression obligation for IAs is managed with U.S. Navy Standard Air Tables corrected for altitude, Bühlmann Tables, and the Nobendem© calculator. IAs also breathe supplemental oxygen while compressed. Presbyterian/St. Luke's (0.83 atmospheres absolute/atm abs) uses gauge pressure, uncorrected for altitude, at 45 feet of sea water (fsw) (2.2 atm abs) for routine wound care HBO2 and 66 fsw (2.8 atm abs) for carbon monoxide/cyanide poisoning. Presbyterian/St. Luke's provides oxygen breathing for the IAs at 2.2 atm abs. At Intermountain (0.86 atm abs), HBO2 is provided at 2.0 atm abs for routine treatments and 3.0 atm abs for carbon monoxide poisoning. Intermountain IAs breathe intermittent 50% nitrogen/50% oxygen at 3.0 atm abs and 100% oxygen at 2.0 atm abs. The chamber profiles include a safety stop. From 1990-2013, Presbyterian/St. Luke's had 26,900 total IA exposures: 25,991 at 45 fsw (2.2 atm abs) and 646 at 66 fsw (2.8 atm abs); there have been four cases of IA DCS. From 2008-2013, Intermountain had 1,847 IA exposures: 1,832 at 2 atm abs and 15 at 3 atm abs, with one case of IA DCS. At both facilities, DCS incidents occurred soon after the chambers were placed into service. Based on these results, chamber inside attendant risk for DCS at increased altitude is low when the inside attendants breathe supplemental oxygen.

  1. Case Descriptions and Observations About Cutis Marmorata From Hypobaric Decompressions (United States)

    Conkin, Johnny; Pilmanis, Andrew A.; Webb, James T.


    There is disagreement about the pathophysiology, classification, and treatment of cutis marmorata (CM), so there is disagreement about the disposition and medical status of a person that had CM. CM is rare, associated with stressful decompressions, and may be associated with serious signs and symptoms of decompression sickness (DCS). CM presents as purple or bluish-red skin mottling, often in the pectoral region, shoulders, chest, or upper abdomen. It is unethical to induce CM in humans so all information comes from retrospective analysis of case reports, or from animal models. A literature search, seven recent case reports from the Johnson Space Center and Brooks Air Force Base Hypobaric DCS Databases, interviews with DCS treatment experts, and responses to surveys provided the factual information used to arrive at our conclusions and recommendations. The "weight of evidence" indicates that CM is a local, not centrally mediated or systemic response to bubbles. It is unclear whether obstruction of arterial or venous blood flow is the primary insult since the lesion is reported under either condition. Any neurological or cardiovascular involvements are coincidental, developing along the same time course. The skin could be the source of the bubbles due to its mass, the associated layer of fat, and the variable nature of skin blood flow. CM should not be categorized as Type II DCS, should be included with other skin manifestations in a category called cutaneous DCS, and hyperbaric treatment is only needed if ground level oxygen is ineffective in the case of altitude-induced CM.

  2. Analyses of Sickness Absence

    NARCIS (Netherlands)

    Heijnen, S.M.M.


    Sickness absence is an empirical phenomenon of all time. Generally, it has a medical cause. However, other factors also appear to have an impact on the actual rate of sickness absence, such as the institutional setting, the business cycle and the economic structure. Many questions on the different

  3. Presenteeism among sick workers

    NARCIS (Netherlands)

    Houtman, I.L.D.


    Much attention has been focused on absenteeism. However, ‘presenteeism’ is also an issue, i.e. staying at work even when feeling sick. Analyses have shown that, the greater the work pressure, the higher the percentage of people who keep working when feeling sick.

  4. Sick of Taxes?

    DEFF Research Database (Denmark)

    Ljunge, Jan Martin

    I estimate a price elasticity of sickness absence. Sick leave is an intensive margin of labor supply where individuals are free to adjust. I exploit variation in tax rates over two decades, which provide thousands of differential incentives across time and space, to estimate the price responsiven...... of sick leave, -0.7, with respect to the net of tax rate. Though large relative to traditional labor supply elasticities, Swedes are half as price elastic as bike messengers, and just as elastic as stadium vendors on the margin which they can adjust freely....

  5. Travelers' Health: Motion Sickness (United States)

    ... sickness, especially when pregnant, menstruating, or on hormones. Race/ethnicity—Asians may be more susceptible to motion ... it, sitting in the front seat of a car or bus, sitting over the wing of an ...

  6. Dizziness and Motion Sickness (United States)

    ... that extends into the inner ear can completely destroy both the hearing and equilibrium function of that ... motion sickness: •Do not read while traveling •Avoid sitting in the rear seat •Do not sit in ...

  7. Acute mountain sickness (United States)

    ... GO About MedlinePlus Site Map FAQs Customer Support Health Topics Drugs & Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Acute mountain sickness URL of this page: // ...

  8. Motion Sickness: First Aid (United States)

    ... com. Accessed July 29, 2017. Priesol AJ. Motion sickness. Accessed July 29, 2017. Brunette GW, et al. CDC Health Information for International Travel 2018. New York, N. ...

  9. Microvascular decompression for trigeminal neuralgia

    International Nuclear Information System (INIS)

    Khan, S.A.; Khan, B.; Khan, A.A.; Afridi, E.A.A.; Mehmood, S.; Muhammad, G.; Hussain, I.; Zadran, K.K.; Bhatti, S.N.


    Background: Trigeminal Neuralgia (TGN) is the most frequently diagnosed type of facial pain. In idiopathic type of TGN it is caused by the neuro-vascular conflict involving trigeminal nerve. Microvascular decompression (MVD) aims at addressing this basic pathology in the idiopathic type of TGN. This study was conducted to determine the outcome and complications of patients with idiopathic TGN undergoing MVD. Method: In a descriptive case series patients with idiopathic TGN undergoing MVD were included in consecutive manner. Patients were diagnosed on the basis of detailed history and clinical examination. Retromastoid approach with craniectomy was used to access cerebellopontine angle (CP-angle) and microsurgical decompression was done. Patients were followed up for 6 months. Results: A total of 53 patients underwent MVD with mean age of 51.6±4.2 years and male predominance. In majority of cases (58.4 percentage) both Maxillary and Mandibular divisions were involved. Per-operatively superior cerebellar artery (SCA) was causing the neuro-vascular conflict in 33 (62.2 percentage) of the cases, anterior inferior cerebellar artery (AICA) in 6 (11.3 percentage) cases, both CSA and AICA in 3 (5.6 percentage) cases, venous compressions in only 1 (1.8percentage) patient and thick arachnoid adhesions were seen in 10 (18.9 percentage) patients. Postoperatively, 33 (68 percentage) patients were pain free, in 14 (26.45 percentage) patients pain was significantly improved whereas in 3 (5.6 percentage) patients there was mild improvement in symptoms. Three (5.6 percentage) patients did not improve after the primary surgery. Cerebrospinal fluid (CSF) leak was encountered in 7 (13.2 percentage) patients post-operatively, 4 (7.5 percentage) patients developed wound infection and 1 (1.8 percentage) patient developed aseptic meningitis. Three (5.6 percentage) patients had transient VII nerve palsy while one patient developed permanent VII nerve palsy. Conclusion: MVD is a safe and

  10. Sick building syndrome

    Directory of Open Access Journals (Sweden)

    Tjandra Y. Aditama


    Full Text Available Sick building syndrome describes a number of mostly unspesific complaints of some occupants of the building. The exact pathophysiological mechanism remains elusive. It is a multi factorial event which may include physical, chemical, biological as well as psycological factors. In many cases it is due to insufficient maintenance of the HVAC (heating, ventilation, air conditioning system in the building. Sign and symptoms can be uncomfortable and even disabling, which may include mucus membrane irritation, neurotoxic symptoms, asthma like symptoms, skin complaints, gastrointestinal symptoms and other related symptoms. There are various investigation methods to diagnose sick building syndrome, and on site assessment of the building is extremely useful. Prevention through a proactive air quality monitoring program is far more desirable than dealing with an actual sick building. Indoor air and the sick building symdrome serves as a paradigm of modern occupational and environmental medicine. (Med J Indones 2002; 11:124-31Keywords: indoor air pollution, sick building syndrome, building related illness

  11. MR imaging of the central nervous system in diving-related decompression illness

    International Nuclear Information System (INIS)

    Reuter, M.; Hutzelmann, A.; Steffens, J.C.; Heller, M.; Fritsch, G.


    Purpose: This investigation was conducted to determine whether MR imaging showed cerebral or spinal damage in acute diving-related decompression illness, a term that includes decompressions sickness (DCS) and arterial gas embolism (AGE). Material and Methods: A total of 16 divers with dysbaric injuries were examined after the initiation of therapeutic recompression. Their injuries comprised: neurological DCS II n=8; AGE n=7; combined cerebral-AGE/spinal-DCS n=1. T1- and T2-weighted images of the brain were obtained in 2 planes. In addition, the spinal cord was imaged in 7 subjects. The imaging findings were correlated with the neurological symptoms. Results: MR images of the head showed ischemic cerebrovascular lesions in 6/8 patients with AGE but showed focal hyperintensities in only 2/8 divers with DCS. Spinal-cord involvement was detected in 1/7 examinations, which was the combined cerebral-AGE/spinal-DCS case. There was agreement between the locations of the documented lesions and the clinical manifestations. Conclusion: MR readily detects cerebral damage in AGE but yields low sensitivity in DCS. A negative MR investigation cannot rule out AGE or DCS. However, MR is useful in the examination of patients with decompression illness. (orig.)

  12. Delayed facial nerve decompression for Bell's palsy. (United States)

    Kim, Sang Hoon; Jung, Junyang; Lee, Jong Ha; Byun, Jae Yong; Park, Moon Suh; Yeo, Seung Geun


    Incomplete recovery of facial motor function continues to be long-term sequelae in some patients with Bell's palsy. The purpose of this study was to investigate the efficacy of transmastoid facial nerve decompression after steroid and antiviral treatment in patients with late stage Bell's palsy. Twelve patients underwent surgical decompression for Bell's palsy 21-70 days after onset, whereas 22 patients were followed up after steroid and antiviral therapy without decompression. Surgical criteria included greater than 90 % degeneration on electroneuronography and no voluntary electromyography potentials. This study was a retrospective study of electrodiagnostic data and medical chart review between 2006 and 2013. Recovery from facial palsy was assessed using the House-Brackmann grading system. Final recovery rate did not differ significantly in the two groups; however, all patients in the decompression group recovered to at least House-Brackmann grade III at final follow-up. Although postoperative hearing threshold was increased in both groups, there was no significant between group difference in hearing threshold. Transmastoid decompression of the facial nerve in patients with severe late stage Bell's palsy at risk for a poor facial nerve outcome reduced severe complications of facial palsy with minimal morbidity.

  13. Sick building syndrome

    International Nuclear Information System (INIS)

    Baechler, M.C.; Hadley, D.L.; Marseille, T.J.; Stenner, R.D.; Peterson, M.R.; Naugle, D.F.; Berry, M.A.


    This book discusses the aspect of indoor air pollution referred to as sick building syndrome. Covered are sources and health effects of various indoor air pollutants, and methods for mitigation of the problem, plus suggested analytical methods for environmental carcinogens found in indoor air

  14. Decompressive craniectomy in herpes simplex encephalitis

    Directory of Open Access Journals (Sweden)

    Muhammed Jasim Abdul Jalal


    Full Text Available Intracranial hypertension is a common cause of morbidity in herpes simplex encephalitis (HSE. HSE is the most common form of acute viral encephalitis. Hereby we report a case of HSE in which decompressive craniectomy was performed to treat refractory intracranial hypertension. A 32-year-old male presented with headache, vomiting, fever, and focal seizures involving the right upper limb. Cerebrospinal fluid-meningoencephalitic profile was positive for herpes simplex. Magnetic resonance image of the brain showed swollen and edematous right temporal lobe with increased signal in gray matter and subcortical white matter with loss of gray, white differentiation in T2-weighted sequences. Decompressive craniectomy was performed in view of refractory intracranial hypertension. Decompressive surgery for HSE with refractory hypertension can positively affect patient survival, with good outcomes in terms of cognitive functions.

  15. The prevalence of sick leave

    DEFF Research Database (Denmark)

    Backhausen, Mette; Damm, Peter; Bendix, Jane


    of long-term sick leave. Method Data from 508 employed pregnant women seeking antenatal care was collected by questionnaires from August 2015 to March 2016. The questionnaires, which were filled in at 20 and 32 weeks of gestation, provided information on maternal characteristics, the number of days spent...... on sick leave and the associated reasons. Descriptive statistics and logistic regression analysis were applied. Results The prevalence of sick leave was 56% of employed pregnant women in the first 32 weeks of gestation and more than one in four reported long-term sick leave (>20 days, continuous...... was a negative predictor. Conclusions The prevalence of sick leave was 56% in the first 32 weeks of gestation and more than one in four women reported long-term sick leave. The majority of reasons for sick leave were pregnancy-related and low back pain was the most frequently given reason....

  16. Surgical Decompression for Traumatic Spinal Cord Injury in a ...

    African Journals Online (AJOL)


    Jan 24, 2018 ... spinal cord decompression with or without spinal stabilization in our region. Methodology: We ... decompression and fixation in this series were surgical site infections (11.4%) and ..... group and died of respiratory failure.

  17. Social inequalities in "sickness"

    DEFF Research Database (Denmark)

    van der Wel, Kjetil A; Dahl, Espen; Thielen, Karsten


    In comparative studies of health inequalities, public health researchers have usually studied only disease and illness. Recent studies have also examined the sickness dimension of health, that is, the extent to which ill health is accompanied by joblessness, and how this association varies...... consistent results. They analyze data from the European Union Statistics on Income and Living Conditions (EU-SILC); health was measured by limiting longstanding illness (LLSI). Results show that for both men and women reporting LLSI in combination with low educational level, the probabilities of non......-employment were particularly high in the Anglo-Saxon and Eastern welfare regimes, and lowest in the Scandinavian regime. For men, absolute and relative social inequalities in sickness were lowest in the Southern regime; for women, inequalities were lowest in the Scandinavian regime. The authors conclude...

  18. Spontaneous extracranial decompression of epidural hematoma

    International Nuclear Information System (INIS)

    Neely, John C.; Jones, Blaise V.; Crone, Kerry R.


    Epidural hematoma (EDH) is a common sequela of head trauma in children. An increasing number are managed nonsurgically, with close clinical and imaging observation. We report the case of a traumatic EDH that spontaneously decompressed into the subgaleal space, demonstrated on serial CT scans that showed resolution of the EDH and concurrent enlargement of the subgaleal hematoma. (orig.)

  19. Spontaneous extracranial decompression of epidural hematoma

    Energy Technology Data Exchange (ETDEWEB)

    Neely, John C. [Marshall University School of Medicine, Huntington, WV (United States); Jones, Blaise V. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Crone, Kerry R. [Cincinnati Children' s Hospital Medical Center, Division of Neurosurgery, Cincinnati, OH (United States)


    Epidural hematoma (EDH) is a common sequela of head trauma in children. An increasing number are managed nonsurgically, with close clinical and imaging observation. We report the case of a traumatic EDH that spontaneously decompressed into the subgaleal space, demonstrated on serial CT scans that showed resolution of the EDH and concurrent enlargement of the subgaleal hematoma. (orig.)

  20. Decompressive craniectomy following brain injury: factors important ...

    African Journals Online (AJOL)


    Jan 7, 2010 ... Background: Decompressive craniectomy (DC) is often performed as an empirical lifesaving measure to protect the injured brain from the damaging effects of propagating oedema and intracranial hypertension. However, there are no clearly defined indications or specified guidelines for patient selection for ...

  1. Severe traumatic brain injury managed with decompressive ...

    African Journals Online (AJOL)


    May 29, 2012 ... Patients with severe taumatic brain injury may develop intractable raised ICP resulting in high mortality ... Glasgow coma score was 8/15 (E1V3M4) and he had left ... An emergency right fronto-temporo-parietal decompressive.

  2. Complications of cranioplasty after decompressive craniectomy

    Directory of Open Access Journals (Sweden)

    Maša Glišović


    Full Text Available Cranioplasty is a surgical repair of a defect or deformity of a skull with the use of autologous bone or synthetic materials.[4] It usually follows decompressive craniectomy, which is a commonly practiced neurosurgical intervention in patients with raised intracranial pressure unresponsive to other forms of treatment.[1] There are many conditions that may lead to intracranial hypertension, and the goal is to avoid brain necrosis caused by compartment pressure syndrome.[2] Consequently, the extensive use of decompressive craniectomy directly results in more cranioplasties, which sometimes present with unwanted complications.[5] Generally, the occurence of cranioplasty complications is between 16% and 34%.[3] Because of the many indications for craniectomy based on clinical data that speak in its favour, if will probably remain a relatively common neurosurgical intervention also in the future. The frequency of decompressive craniectomy and consequently of cranioplasty requires awareness of the many potential postoperative complications and understanding of its evolution. This article is a review of pathophysiological mechanisms after decompressive craniectomy and cranioplasty, of its complications and factors that potentially contribute to their occurence.

  3. A Pottery Electric Kiln Using Decompression (United States)

    Naoe, Nobuyuki; Yamada, Hirofumi; Nakayama, Tetsuo; Nakayama, Minoru; Minamide, Akiyuki; Takemata, Kazuya

    This paper presents a novel type electric kiln which fires the pottery using the decompression. The electric kiln is suitable for the environment and the energy saving as the pottery furnace. This paper described the baking principle and the baking characteristic of the novel type electric kiln.


    Directory of Open Access Journals (Sweden)

    Jakub Krzeszowiak


    Full Text Available This paper presents the most likely pathophysiological causes of the development of acute mountain sickness (AMS, also known as altitude sickness, its pulmonary form i.e. high altitude pulmonary edema (HAPE, and high altitude cerebral edema (HACE. These diseases constitute extraordinary environmental hazards because they are directly connected with low atmospheric pressure, and thus low partial oxygen pressure. The above adverse atmospheric conditions start to affect humans already at an altitude of 2,500 meters above the sea level and, coupled with extreme physical exertion, can quickly lead to respiratory alkalosis, which is not present under any other conditions in the lowlands. Mountaineering above 4,500 m a.s.l. leads to hypoxia of internal organs and, primarily, reduced renal perfusion with all its consequences. The above adverse changes, combined with inadequate acclimatization, can lead to a situation of imminent danger to life and health. This paper describes in detail the consequences of acute mountain sickness, which can ultimately lead to the development of AMS and one of severe forms of HACE and/or HAPE.

  5. Pictorial essay: Role of ultrasound in failed carpal tunnel decompression

    Directory of Open Access Journals (Sweden)

    Rajesh Botchu


    Full Text Available USG has been used for the diagnosis of carpal tunnel syndrome. Scarring and incomplete decompression are the main causes for persistence or recurrence of symptoms. We performed a retrospective study to assess the role of ultrasound in failed carpal tunnel decompression. Of 422 USG studies of the wrist performed at our center over the last 5 years, 14 were for failed carpal tunnel decompression. Scarring was noted in three patients, incomplete decompression in two patients, synovitis in one patient, and an anomalous muscle belly in one patient. No abnormality was detected in seven patients. We present a pictorial review of USG findings in failed carpal tunnel decompression.

  6. Pictorial essay: Role of ultrasound in failed carpal tunnel decompression. (United States)

    Botchu, Rajesh; Khan, Aman; Jeyapalan, Kanagaratnam


    USG has been used for the diagnosis of carpal tunnel syndrome. Scarring and incomplete decompression are the main causes for persistence or recurrence of symptoms. We performed a retrospective study to assess the role of ultrasound in failed carpal tunnel decompression. Of 422 USG studies of the wrist performed at our center over the last 5 years, 14 were for failed carpal tunnel decompression. Scarring was noted in three patients, incomplete decompression in two patients, synovitis in one patient, and an anomalous muscle belly in one patient. No abnormality was detected in seven patients. We present a pictorial review of USG findings in failed carpal tunnel decompression.

  7. 20 CFR 218.28 - Sick pay. (United States)


    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Sick pay. 218.28 Section 218.28 Employees... Beginning Date § 218.28 Sick pay. (a) From railroad employer. If the employee is carried on the payroll while sick, the annuity can begin no earlier than the day after the last day of sick pay. However, sick...

  8. Morning Sickness: Nausea and Vomiting of Pregnancy (United States)

    ... About ACOG Morning Sickness: Nausea and Vomiting of Pregnancy Home For Patients Search FAQs Morning Sickness: Nausea ... PDF Format Morning Sickness: Nausea and Vomiting of Pregnancy Pregnancy How common is nausea and vomiting of ...

  9. Nanobubbles Form at Active Hydrophobic Spots on the Luminal Aspect of Blood Vessels: Consequences for Decompression Illness in Diving and Possible Implications for Autoimmune Disease—An Overview

    Directory of Open Access Journals (Sweden)

    Ran Arieli


    Full Text Available Decompression illness (DCI occurs following a reduction in ambient pressure. Decompression bubbles can expand and develop only from pre-existing gas micronuclei. The different hypotheses hitherto proposed regarding the nucleation and stabilization of gas micronuclei have never been validated. It is known that nanobubbles form spontaneously when a smooth hydrophobic surface is submerged in water containing dissolved gas. These nanobubbles may be the long sought-after gas micronuclei underlying decompression bubbles and DCI. We exposed hydrophobic and hydrophilic silicon wafers under water to hyperbaric pressure. After decompression, bubbles appeared on the hydrophobic but not the hydrophilic wafers. In a further series of experiments, we placed large ovine blood vessels in a cooled high pressure chamber at 1,000 kPa for about 20 h. Bubbles evolved at definite spots in all the types of blood vessels. These bubble-producing spots stained positive for lipids, and were henceforth termed “active hydrophobic spots” (AHS. The lung surfactant dipalmitoylphosphatidylcholine (DPPC, was found both in the plasma of the sheep and at the AHS. Bubbles detached from the blood vessel in pulsatile flow after reaching a mean diameter of ~1.0 mm. Bubble expansion was bi-phasic—a slow initiation phase which peaked 45 min after decompression, followed by fast diffusion-controlled growth. Many features of decompression from diving correlate with this finding of AHS on the blood vessels. (1 Variability between bubblers and non-bubblers. (2 An age-related effect and adaptation. (3 The increased risk of DCI on a second dive. (4 Symptoms of neurologic decompression sickness. (5 Preconditioning before a dive. (6 A bi-phasic mechanism of bubble expansion. (7 Increased bubble formation with depth. (8 Endothelial injury. (9 The presence of endothelial microparticles. Finally, constant contact between nanobubbles and plasma may result in distortion of proteins and their

  10. Emergency percutaneous needle decompression for tension pneumoperitoneum

    Directory of Open Access Journals (Sweden)

    Körner Markus


    Full Text Available Abstract Background Tension pneumoperitoneum as a complication of iatrogenic bowel perforation during endoscopy is a dramatic condition in which intraperitoneal air under pressure causes hemodynamic and ventilatory compromise. Like tension pneumothorax, urgent intervention is required. Immediate surgical decompression though is not always possible due to the limitations of the preclinical management and sometimes to capacity constraints of medical staff and equipment in the clinic. Methods This is a retrospective analysis of cases of pneumoperitoneum and tension pneumoperitoneum due to iatrogenic bowel perforation. All patients admitted to our surgical department between January 2005 and October 2010 were included. Tension pneumoperitoneum was diagnosed in those patients presenting signs of hemodynamic and ventilatory compromise in addition to abdominal distension. Results Between January 2005 and October 2010 eleven patients with iatrogenic bowel perforation were admitted to our surgical department. The mean time between perforation and admission was 36 ± 14 hrs (range 30 min - 130 hrs, between ER admission and begin of the operation 3 hrs and 15 min ± 47 min (range 60 min - 9 hrs. Three out of eleven patients had clinical signs of tension pneumoperitoneum. In those patients emergency percutaneous needle decompression was performed with a 16G venous catheter. This improved significantly the patients' condition (stabilization of vital signs, reducing jugular vein congestion, bridging the time to the start of the operation. Conclusions Hemodynamical and respiratory compromise in addition to abdominal distension shortly after endoscopy are strongly suggestive of tension pneumoperitoneum due to iatrogenic bowel perforation. This is a rare but life threatening condition and it can be managed in a preclinical and clinical setting with emergency percutaneous needle decompression like tension pneumothorax. Emergency percutaneous decompression is no

  11. Sickness and love: an introduction

    NARCIS (Netherlands)

    van der Geest, S.; Vandamme, S.


    Love is a neglected topic in anthropology, for good reasons: it has always resisted scientific definition and analysis. By associating love with sickness seven authors attempt to capture various meanings and experiences of love. Two broad concepts arise: love as sickness and love in response to

  12. Decompression Sickness, Extravehicular Activities, and Nitrogen Induced Osmosis: Brian Hills Revisited (United States)


    hypobares ou hyperbares ] To order the complete compilation report, use: ADA395680 The component part is provided here to allow users access to TITLE: Operational Medical Issues in Hypo-and Hyperbaric Conditions [les Questions medicales a caractere oprationel liees aux conditions...Hypo- and Hyperbaric Conditions ", held in Toronto, Canada, 16-19 October 2000, and published in RTO MP-062. 45-2 upon the local pressure differential

  13. The Influence of Thermal Exposure on Diver Susceptibility to Decompression Sickness (United States)


    day. Wet pot pressure was monitored with a Druck 0-150 pounds per square inch gauge (psig) pressure transducer (G. E. Sensing; New Fairfield, CT...Neurological examination was within normal limits except for the loss of pinpoint sensation over dorsal surface of the 3d , 4 h, and 5 h digits of the...right hand up to the knuckle region and loss of two-point discrimination over 3d and 4 h digit palmer surface. Intense pruritis remained as did 4/10 pain

  14. Development of an Operational Altitude Decompression Sickness Computer Model: Feasibility Study Results (United States)


    1955;36pp. 44. Eger El. II. A mathematical model of uptake and distribution, ch. 7, pp.72-87 In E. M. Papper and R. J. Kitz (eds.). Uptake and...Space Environ. Med. 1992;63:386. 119. Papper EM and Kitz RJ. Uptake and distribution of anesthetic agents. New York: McGraw Hill, 1963. 67 120. Per W and

  15. Risk of Central Nervous System Decompression Sickness in Air Diving to No-Stop Limits (United States)


    190 9 1 10 1. Weak, faint, vertigo 2. Heavy legs, abnormal gait 3. Vertigo and cardiorespiratory symptoms 4. Bilateral numbness and paresthesia ...original report," were included. 6. Pain in both feet, paresthesia 7. Hearing deficit, anisocoria, nystagmus, confusion, emotionally labile, abnormal...tandem gait 8. Scintillating scotoma, abnormal left foot dorsiflexion 9. Weakness, general left side paresthesia , numbness, abnormal gait 10. See

  16. Comparative incidences of decompression illness in repetitive, staged, mixed-gas decompression diving: is 'dive fitness' an influencing factor? (United States)

    Sayer, Martin Dj; Akroyd, Jim; Williams, Guy D


    Wreck diving at Bikini Atoll consists of a relatively standard series of decompression dives with maximum depths in the region of 45-55 metres' sea water (msw). In a typical week of diving at Bikini, divers can perform up to 12 decompression dives to these depths over seven days; on five of those days, divers can perform two decompression dives per day. All the dives employ multi-level, staged decompression schedules using air and surface-supplied nitrox containing 80% oxygen. Bikini is serviced by a single diving operator and so a relatively precise record exists both of the actual number of dives undertaken and of the decompression illness incidents both for customer divers and the dive guides. The dive guides follow exactly the dive profiles and decompression schedules of the customers. Each dive guide will perform nearly 400 decompression dives a year, with maximum depths mostly around 50 msw, compared with an average of 10 (maximum of 12) undertaken typically by each customer diver in a week. The incidence of decompression illness for the customer population (presumed in the absence of medical records) is over ten times higher than that for the dive guides. The physiological reasons for such a marked difference are discussed in terms of customer demographics and dive-guide acclimatization to repetitive decompression stress. The rates of decompression illness for a range of diving populations are reviewed.

  17. Motion sickness in ancient China: Seasickness and cart-sickness. (United States)

    Brandt, Thomas; Bauer, Matthias; Benson, Judy; Huppert, Doreen


    To find and analyze descriptions of motion sickness in Chinese historical sources. Databases and dictionaries were searched for various terms for seasickness and travel sickness, which were then entered into databases of full texts allowing selection of relevant passages from about the third to the 19th century ad. Already in 300 ad the Chinese differentiated cart-sickness, particularly experienced by persons from the arid north of China, from a ship-illness experienced by persons from the south, where rivers were important for transportation and travel. In the Middle Ages, a third form of motion sickness was called litter-influence experienced by persons transported in a bed suspended between 2 long poles. The ancient Chinese recognized the particular susceptibility of children to motion sickness. Therapeutic recommendations include drinking the urine of young boys, swallowing white sand-syrup, collecting water drops from a bamboo stick, or hiding some earth from the middle of the kitchen hearth under the hair. The Chinese medical classics distinguished several forms of travel sickness, all of which had their own written characters. The pathophysiologic mechanism was explained by the medicine of correspondences, which was based on malfunctions within the body, its invasion by external pathogens like wind, or the deficit or surfeit of certain bodily substances such as the life force Qi. The concept of motion as the trigger of sickness initially appeared in a chapter on warding off the influence of demons and corpses, e.g., ancient magic and beliefs. © 2016 American Academy of Neurology.

  18. Sick boat syndrome

    Directory of Open Access Journals (Sweden)

    Dąbrowiecki Zbigniew


    Full Text Available Many pathogenic micro-organisms are likely to attack passengers of cruise ships and other vessels or travel between continents as a peculiar type of a “stowaway”. The epidemiological tests conducted since 1987 with regard to watercraft led to the coining of a term known as the Sick Boat Syndrome (SBS. The main illnesses encountered on watercraft include gastrointestinal diseases (foodborne and Legionellosis. Additionally, the ventilation and airconditioning systems of old commercial ships (the so-called Tramps constitute a real technical challenge. Conditioned air (with removed undesired odour and micro-organisms should constitute ca. 25% of circulating air. In practice this situation is not typical for vessels of this class. Unclean air poses a real hazard for the crew.

  19. Social inequalities in 'sickness'

    DEFF Research Database (Denmark)

    Wel, Kjetil A. van der; Dahl, Espen; Thielen, Karsten


    The aim of this paper is to examine educational inequalities in the risk of non-employment among people with illnesses and how they vary between European countries with different welfare state characteristics. In doing so, the paper adds to the growing literature on welfare states and social...... from Eurostat and OECD that include spending on active labour market policies, benefit generosity, income inequality, and employment protection. Using multilevel techniques we find that comprehensive welfare states have lower absolute and relative social inequalities in sickness, as well as more...... inequalities in health by studying the often overlooked ‘sickness’-dimension of health, namely employment behaviour among people with illnesses. We use European Union Statistics on Income and Living Conditions (EU-SILC) data from 2005 covering 26 European countries linked to country characteristics derived...

  20. [Workplace bullying and sickness absenteeism]. (United States)

    Campanini, Paolo; Conway, Paul Maurice; Neri, Luca; Punzi, Silvia; Camerino, Donatella; Costa, Giovanni


    To assess the relationship between workplace bullying and sickness absenteeism in a large sample of Italian workers. A cross-sectional study conducted by means of questionnaires. In all, 8,992 subjects filled in a questionnaire to detect workplace bullying, the presence of work stress factors and days of sickness absence in the last year. Workplace bullying and psychosocial stressor were measured by the means of the CDL 2.0 questionnaire. Days of sickness absence reported by the subjects. On average, days of sickness absence were 7.4, and 7.2% of the respondents were defined as bullied. Results from logistic regression analyses showed that a workplace bullying was associated with more days of sickness absence after controlling for gender, age, professional qualification, company sector and juridical nature and other psychosocial factors (men: OR =1.62; women: OR =2.15). The present study confirms that workers exposed to a workplace bullying reported higher sickness absenteeism as compared with non-exposed subjects, also when a potentially highly stressful work environment is considered. The results of the present study support that workplace bullying may be viewed as an extreme stressful condition. Interventions to avoid workplace bullying not only favoure workers' health, but also avoid the company costs associated with workers' sickness absenteeism.

  1. Industrial Sickness in Indian Manufacturing


    Falk, Rahel


    In India, the term ‘sick units’ refers to economically unviable firms which are kept alive ‘in the public interest’ by means of subsidies of various kinds. Since this practice is common, and large parts of the industrial sector are affected, this phenomenon is referred to as industrial sickness. As of March 2001, the Reserve Bank of India counted over a quarter of a million of sick units with outstanding credit worth more than a quarter of a trillion of Indian Rupees, i.e. about 1.2 percent o...

  2. Joint pain and Doppler-detectable bubbles in altitude (Hypobaric) decompression (United States)

    Powell, Michael R.


    The observation that altitude decompression sickness (DCS) is associated with pain in the lower extremities is not new, although it is not a consistent finding. DCS in divers is generally in the upper body, an effect often attributed to non-loading of the body while immersed. In caisson workers, DCS is reported more in the lower extremities. Surprisingly, many researchers do not mention the location of DCS joint pain, apparently considering it to be random. This is not the case for the tissue ratios encountered in studying decompression associated with simulated EVA. In NASA/JSC tests, altitude DCS generally presented first in either the ankle, knee, or hip (83 percent = 73/88). There was a definite statistical relation between the maximum Spencer precordial Doppler Grade and the incidence of DCS in the extremity, although this is not meant to imply a casual relation between circulating gas bubbles and joint pain. The risk of DCS with Grade 4 was considerably higher than that of Grades 0 to 3. The DCS risk was independent of the 'tissue ratio.' There was a predominance of lower extremity DCS even when exercise was performed with the upper body. The reason for these locations we hypothesize to be attributed to the formation of tissue gas micronuclei from kinetic and tensile forces (stress-assisted nucleation) and are the result of the individuals ambulating in a 1g environment. Additionally, since these showers of Doppler bubbles can persist for hours, it is difficult to imagine that they are emanating solely from tendons and ligaments, the supposed site of joint pain. This follows from Henry's law linking the volume of joint tissue (the solvent) and the solubility coefficient of inert gas; there is volumetrically insufficient connective tissue to produce the prolonged release of gas bubbles. If gas bubbles are spawned and released from connective tissue, their volume is increased by those from muscle tissue. Therefore, the nexus between Doppler-detectable gas

  3. Cardiovascular Pressures with Venous Gas Embolism and Decompression (United States)

    Butler, B. D.; Robinson, R.; Sutton, T.; Kemper, G. B.


    Venous gas embolism (VGE) is reported with decompression to a decreased ambient pressure. With severe decompression, or in cases where an intracardiac septal defect (patent foramen ovale) exists, the venous bubbles can become arterialized and cause neurological decompression illness. Incidence rates of patent foramen ovale in the general population range from 25-34% and yet aviators, astronauts, and deepsea divers who have decompression-induced venous bubbles do not demonstrate neurological symptoms at these high rates. This apparent disparity may be attributable to the normal pressure gradient across the atria of the heart that must be reversed for there to be flow potency. We evaluated the effects of: venous gas embolism (0.025, 0.05 and 0.15 ml/ kg min for 180 min.) hyperbaric decompression; and hypobaric decompression on the pressure gradient across the left and right atria in anesthetized dogs with intact atrial septa. Left ventricular end-diastolic pressure was used as a measure of left atrial pressure. In a total of 92 experimental evaluations in 22 dogs, there were no reported reversals in the mean pressure gradient across the atria; a total of 3 transient reversals occurred during the peak pressure gradient changes. The reasons that decompression-induced venous bubbles do not consistently cause serious symptoms of decompression illness may be that the amount of venous gas does not always cause sufficient pressure reversal across a patent foramen ovale to cause arterialization of the venous bubbles.

  4. Collagen levels are normalized after decompression of experimentally obstructed colon

    DEFF Research Database (Denmark)

    Rehn, Martin; Ågren, Sven Per Magnus; Syk, I


    Our aim was to define the dynamics in collagen concentrations in the large bowel wall following decompression of experimental obstruction.......Our aim was to define the dynamics in collagen concentrations in the large bowel wall following decompression of experimental obstruction....

  5. Space sickness on earth (United States)

    Nooij, S. A. E.; Bos, J. E.; Groen, E. L.; Bles, W.; Ockels, W. J.


    During the first days in space, i.e., after a transition from 1G to 0G, more than 50% of the astro- (and cosmonauts) suffer from the Space Adaptation Syndrome (SAS).The symptoms of SAS, like nausea and dizziness, are especially provoked by head movements. Astronauts have mentioned close similarities between the symptoms of SAS and the symptoms they experienced after a 1 hour centrifuge run on Earth, i.e., after a transition from 3G to 1G (denoted by Sickness Induced by Centrifugation, SIC). During several space missions, we related susceptibility to SAS and to SIC in 11 astronauts and found 4 of them being susceptible to both SIC and SAS, and 7 being not susceptible to SIC nor to SAS. This correspondence in susceptibility suggests that SIC and SAS share the same underlying mechanism. To further study this mechanism, several vestibular parameters have been investigated (e.g. postural stability, vestibularly driven eye movements, subjective vertical). We found some striking changes in individual cases that are possibly due to the centrifuge run. However, the variability between subjects generally is very large, making physiological links to SIC and SAS still hard to find.

  6. Needle Decompression of Tension Pneumothorax with Colorimetric Capnography. (United States)

    Naik, Nimesh D; Hernandez, Matthew C; Anderson, Jeff R; Ross, Erika K; Zielinski, Martin D; Aho, Johnathon M


    The success of needle decompression for tension pneumothorax is variable, and there are no objective measures assessing effective decompression. Colorimetric capnography, which detects carbon dioxide present within the pleural space, may serve as a simple test to assess effective needle decompression. Three swine underwent traumatically induced tension pneumothorax (standard of care, n = 15; standard of care with needle capnography, n = 15). Needle thoracostomy was performed with an 8-cm angiocatheter. Similarly, decompression was performed with the addition of colorimetric capnography. Subjective operator assessment of decompression was recorded and compared with true decompression, using thoracoscopic visualization for both techniques. Areas under receiver operating curves were calculated and pairwise comparison was performed to assess statistical significance (P pneumothorax, that is, the absence of any pathologic/space-occupying lesion, in 100% of cases (10 of 10 attempts). Standard of care needle decompression was detected by operators in 9 of 15 attempts (60%) and was detected in 3 of 10 attempts when tension pneumothorax was not present (30%). True decompression, under direct visualization with thoracoscopy, occurred 15 of 15 times (100%) with capnography, and 12 of 15 times (80%) without capnography. Areas under receiver operating curves were 0.65 for standard of care and 1.0 for needle capnography (P = .002). Needle decompression with colorimetric capnography provides a rapid, effective, and highly accurate method for eliminating operator bias for tension pneumothorax decompression. This may be useful for the treatment of this life-threatening condition. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  7. Cinerama sickness and postural instability. (United States)

    Bos, Jelte E; Ledegang, Wietse D; Lubeck, Astrid J A; Stins, John F


    Motion sickness symptoms and increased postural instability induced by motion pictures have been reported in a laboratory, but not in a real cinema. We, therefore, carried out an observational study recording sickness severity and postural instability in 19 subjects before, immediately and 45 min after watching a 1 h 3D aviation documentary in a cinema. Sickness was significantly larger right after the movie than before, and in a lesser extent still so after 45 min. The average standard deviation of the lateral centre of pressure excursions was significantly larger only right afterwards. When low-pass filtered at 0.1 Hz, lateral and for-aft excursions were both significantly larger right after the movie, while for-aft excursions then remained larger even after 45 min. Speculating on previous findings, we predict more sickness and postural instability in 3D than in 2D movies, also suggesting a possible, but yet unknown risk for work-related activities and vehicle operation. Watching motion pictures may be sickening and posturally destabilising, but effects in a cinema are unknown. We, therefore, carried out an observational study showing that sickness then is mainly an issue during the exposure while postural instability is an issue afterwards.

  8. The sick-building syndrome; Das Sick-Building-Syndrom

    Energy Technology Data Exchange (ETDEWEB)

    Henne, A.; Neumann, H.F.; Winneke, G.


    The sick-building syndrome is characterized by the presence of general, non-specific symptoms (e.g., headache, tiredness, respiratory problems, eye trouble, vertigo, nausea, unspecific hypersensitivity) in association with a particular indoor ambience. It is clearly distinguishable from `building-related illness`, referring to a well-defined clinical syndrome due to staying in a building and for which a cause can, in general, be established. Disorders in the case of the sick-building syndrome are manifold and confirmed objectifiable results are hardly available so far. Yet there are some organ-related methods for the confirmation of findings concerning, for instance, the eyes, the skin and the area of the nose. The causes of the incidence of sick-building syndrome are more or less unclear. It is a multifactorial phenomenon involving physical, biological, chemical, individual-specific and psychological factors. Buildings where sick-building syndrome occurs typically exhibit certain properties. The European Community has already made proposals for the investigation of incriminated buildings. A systematic survey by questionnaire together with individual interviews plays an import part towards clarifying the syndrome. (orig./UWA) [Deutsch] Das Sick-Building-Syndrom beschreibt das Vorhandensein von allgemeinen, nicht spezifischen Symptomen (z.B. Kopfschmerzen, Muedigkeit, Atembeschwerden, Augenreizungen, Schwindelgefuehl, Uebelkeit, unspezifische Ueberempfindlichkeit), assoziiert mit einer besonderen Innenraumumgebung. Deutlich hiervon abzugrenzen ist die ``Building related illness``, bei der ein klinisch definiertes Krankheitsbild vorliegt, das durch den Aufenthalt im Gebaeude verursacht wird und fuer das im allgemeinen eine Ursache ermittelt werden kann. Das Beschwerdebild beim Sick-Building-Syndrom ist vielfaeltig, und gesicherte, objektivierbare Befunde liegen hierzu bisher kaum vor. Dennoch gibt es einige organbezogenen Methoden zur Befundabsicherung, z.B. fuer das

  9. [Decompression problems in diving in mountain lakes]. (United States)

    Bühlmann, A A


    The relationship between tolerated high-pressure tissue nitrogen and ambient pressure is practically linear. The tolerated nitrogen high pressure decreases at altitude, as the ambient pressure is lower. Additionally, tissues with short nitrogen half-times have a higher tolerance than tissues which retain nitrogen for longer duration. For the purpose of determining safe decompression routines, the human body can be regarded as consisting of 16 compartments with half-times from 4 to 635 minutes for nitrogen. The coefficients for calculation of the tolerated nitrogen-high pressure in the tissues can be deduced directly from the half-times for nitrogen. We show as application the results of 573 simulated air dives in the pressure-chamber and 544 real dives in mountain lakes in Switzerland (1400-2600 m above sea level) and in Lake Titicaca (3800 m above sea level). They are in accordance with the computed limits of tolerance.

  10. Exercises may be as efficient as subacromial decompression in patients with subacromial stage II impingement: 4-8-years' follow-up in a prospective, randomized study

    DEFF Research Database (Denmark)

    Haahr, J. P.; Andersen, JH


    with graded physiotherapy and exercises or arthroscopic subacromial decompression. Outcomes were proportion of time per year with income transfers (indexed 0-1), including total transfers (marginalization), sick leave and disability pension obtained from the registry at the Ministry of Work. Self......-reported function, working capability, employment status and global improvement were obtained by questionnaire in September 2004. The main outcomes are given as differences in development from baseline. RESULTS: Seventy-nine (88%) responded to the questionnaire and registry data were obtained from 81. After 1 year...

  11. Hyperventilation in a motion sickness desensitization program

    NARCIS (Netherlands)

    Mert, A.; Bles, W.; Nooij, S.A.E.


    Introduction: In motion sickness desensitization programs, the motion sickness provocative stimulus is often a forward bending of the trunk on a rotating chair, inducing Coriolis effects. Since respiratory relaxation techniques are applied successfully in these courses, we investigated whether these

  12. Sleeping Sickness Surveillance In The Abraka Sleeping Sickness ...

    African Journals Online (AJOL)

    Confirmation of sleeping sickness (ss) was by the detection of trypanosomes in blood, body fluids and biopsy tissues. Thirteen (0.8%) seropositive subjects were parasitologically confirmed and treated with melasoprol at the Baptist Medical Centre (BMC) Eku. One (0.06%) patient died during the course of treatment.

  13. 46 CFR 197.332 - PVHO-Decompression chambers. (United States)


    .... Each decompression chamber must— (a) Meet the requirements of § 197.328; (b) Have internal dimensions... pressure; (d) Have a means of operating all installed man-way locking devices, except disabled shipping...

  14. Decompression to altitude: assumptions, experimental evidence, and future directions. (United States)

    Foster, Philip P; Butler, Bruce D


    Although differences exist, hypobaric and hyperbaric exposures share common physiological, biochemical, and clinical features, and their comparison may provide further insight into the mechanisms of decompression stress. Although altitude decompression illness (DCI) has been experienced by high-altitude Air Force pilots and is common in ground-based experiments simulating decompression profiles of extravehicular activities (EVAs) or astronauts' space walks, no case has been reported during actual EVAs in the non-weight-bearing microgravity environment of orbital space missions. We are uncertain whether gravity influences decompression outcomes via nitrogen tissue washout or via alterations related to skeletal muscle activity. However, robust experimental evidence demonstrated the role of skeletal muscle exercise, activities, and/or movement in bubble formation and DCI occurrence. Dualism of effects of exercise, positive or negative, on bubble formation and DCI is a striking feature in hypobaric exposure. Therefore, the discussion and the structure of this review are centered on those highlighted unresolved topics about the relationship between muscle activity, decompression, and microgravity. This article also provides, in the context of altitude decompression, an overview of the role of denitrogenation, metabolic gases, gas micronuclei, stabilization of bubbles, biochemical pathways activated by bubbles, nitric oxide, oxygen, anthropometric or physiological variables, Doppler-detectable bubbles, and potential arterialization of bubbles. These findings and uncertainties will produce further physiological challenges to solve in order to line up for the programmed human return to the Moon, the preparation for human exploration of Mars, and the EVAs implementation in a non-zero gravity environment.

  15. Piezosurgery in Modified Pterional Orbital Decompression Surgery in Graves Disease. (United States)

    Grauvogel, Juergen; Scheiwe, Christian; Masalha, Waseem; Jarc, Nadja; Grauvogel, Tanja; Beringer, Andreas


    Piezosurgery uses microvibrations to selectively cut bone, preserving the adjacent soft tissue. The present study evaluated the use of piezosurgery for bone removal in orbital decompression surgery in Graves disease via a modified pterional approach. A piezosurgical device (Piezosurgery medical) was used in 14 patients (20 orbits) with Graves disease who underwent orbital decompression surgery in additional to drills and rongeurs for bone removal of the lateral orbital wall and orbital roof. The practicability, benefits, and drawbacks of this technique in orbital decompression surgery were recorded. Piezosurgery was evaluated with respect to safety, preciseness of bone cutting, and preservation of the adjacent dura and periorbita. Preoperative and postoperative clinical outcome data were assessed. The orbital decompression surgery was successful in all 20 orbits, with good clinical outcomes and no postoperative complications. Piezosurgery proved to be a safe tool, allowing selective bone cutting with no damage to the surrounding soft tissue structures. However, there were disadvantages concerning the intraoperative handling in the narrow space and the efficiency of bone removal was limited in the orbital decompression surgery compared with drills. Piezosurgery proved to be a useful tool in bone removal for orbital decompression in Graves disease. It is safe and easy to perform, without any danger of damage to adjacent tissue because of its selective bone-cutting properties. Nonetheless, further development of the device is necessary to overcome the disadvantages in intraoperative handling and the reduced bone removal rate. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Decompressive craniectomy and CSF disorders in children. (United States)

    Manfiotto, Marie; Mottolese, Carmine; Szathmari, Alexandru; Beuriat, Pierre-Aurelien; Klein, Olivier; Vinchon, Matthieu; Gimbert, Edouard; Roujeau, Thomas; Scavarda, Didier; Zerah, Michel; Di Rocco, Federico


    Decompressive craniectomy (DC) is a lifesaving procedure but is associated to several post-operative complications, namely cerebrospinal fluid (CSF) dynamics impairment. The aim of this multicentric study was to evaluate the incidence of such CSF alterations after DC and review their impact on the overall outcome. We performed a retrospective multicentric study to analyze the CSF disorders occurring in children aged from 0 to 17 years who had undergone a DC for traumatic brain injury (TBI) in the major Departments of Pediatric Neurosurgery of France between January 2006 and August 2016. Out of 150 children, ranging in age between 7 months and 17 years, mean 10.75 years, who underwent a DC for TBI in 10 French pediatric neurosurgical centers. Sixteen (6 males, 10 females) (10.67%) developed CSF disorders following the surgical procedure and required an extrathecal CSF shunting. External ventricular drainage increased the risk of further complications, especially cranioplasty infection (p = 0.008). CSF disorders affect a minority of children after DC for TBI. They may develop early after the DC but they may develop several months after the cranioplasty (8 months), consequently indicating the necessity of clinical and radiological close follow-up after discharge from the neurosurgical unit. External ventricular drainage and permanent CSF shunt placement increase significantly the risk of cranioplasty infection.

  17. Ultrastructural changes of compressed lumbar ventral nerve roots following decompression

    International Nuclear Information System (INIS)

    El-Barrany, Wagih G.; Hamdy, Raid M.; Al-Hayani, Abdulmonem A.; Jalalah, Sawsan M.; Al-Sayyad, Mohammad J.


    To study whether there will be permanent lumbar nerve rot scanning or degeneration secondary to continuous compression followed by decompression on the nerve roots, which can account for postlaminectomy leg weakness or back pain. The study was performed at the Department of Anatomy, Faulty of Medicine, king Abdulaziz University, Jeddah, Kingdom of Saudi Arabia during 2003-2005. Twenty-six adult male New Zealand rabbits were used in the present study. The ventral roots of the left fourth lumbar nerve were clamped for 2 weeks then decompression was allowed by removal of the clips. The left ventral roots of the fourth lumbar nerve were excised for electron microscopic study. One week after nerve root decompression, the ventral root peripheral to the site of compression showed signs of Wallerian degeneration together with signs of regeneration. Schwann cells and myelinated nerve fibers showed severe degenerative changes. Two weeks after decompression, the endoneurium of the ventral root showed extensive edema with an increase in the regenerating myelinated and unmyentilated nerve fibers, and fibroblasts proliferation. Three weeks after decompression, the endoneurium showed an increase in the regenerating myelinated and unmyelinated nerve fibers with diminution of the endoneurial edema, and number of macrophages and an increase in collagen fibrils. Five and 6 weeks after decompression, the endoneurium showed marked diminution of the edema, macrophages, mast cells and fibroblasts. The enoneurium was filed of myelinated and unmyelinated nerve fibers and collagen fibrils. Decompression of the compressed roots of a spinal nerve is followed by regeneration of the nerve fibers and nerve and nerve recovery without endoneurial scarring. (author)

  18. Dysphonia and dysphagia after anterior cervical decompression. (United States)

    Tervonen, Hanna; Niemelä, Mika; Lauri, Eija-Riitta; Back, Leif; Juvas, Anja; Räsänen, Pirjo; Roine, Risto P; Sintonen, Harri; Salmi, Tapani; Vilkman, S Erkki; Aaltonen, Leena-Maija


    In this paper, the authors investigate the effects of anterior cervical decompression (ACD) on swallowing and vocal function. The study comprised 114 patients who underwent ACD. The early group (50 patients) was examined immediately pre- and postoperatively, and the late group (64 patients) was examined at only 3 to 9 months postoperatively. Fifty age- and sex-matched patients from the Department of Otorhinolaryngology-Head and Neck Surgery who had not been intubated in the previous 5 years were used as a control group. All patients in the early and control groups were examined by a laryngologist; patients in the late group were examined by a laryngologist and a neurosurgeon. Videolaryngostroboscopy was performed in all members of the patient and control groups, and the function of the ninth through 12th cranial nerves were clinically evaluated. Data were collected concerning swallowing, voice quality, surgery results, and health-related quality of life. Patients with persistent dysphonia were referred for phoniatric evaluation and laryngeal electromyography (EMG). Those with persistent dysphagia underwent transoral endoscopic evaluation of swallowing function and videofluorography. Sixty percent of patients in the early group reported dysphonia and 69% reported dysphagia at the immediate postoperative visit. Unilateral vocal fold paresis occurred in 12%. The prevalence of both dysphonia and dysphagia decreased in both groups 3 to 9 months postoperatively. All six patients with vocal fold paresis in the early group recovered, and in the late group there were two cases of vocal fold paresis. The results of laryngeal EMG were abnormal in 14 of 16 patients with persistent dysphonia. Neither intraoperative factors nor age or sex had any effect on the occurrence of dysphonia, dysphagia, or vocal fold paresis. Most patients were satisfied with the surgical outcome. Dysphonia, dysphagia, and vocal fold paresis are common but usually transient complications of ACD

  19. Tight or sick building syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Thirumalaikolundusubramanian, P; Shanmuganadan, S [Madurai Kamaraj Univ. (India). Dept. of Geography; Uma, A [Madurai Medical Coll. (India). Dept. of Medicine and Microbiology


    Modern buildings are designed with the usual heating, air-conditioning and ventilation equipment. In most of these buildings, air is continuously recirculated and, as a result, workers suffer from tight or sick building syndrome. This syndrome is discussed with reference to symptoms of air contamination, ventilation system standards and research needs. The most common symptoms of tight building syndrome are eye, nose and throat irritation, headache, fatigue, sneezing, difficulty in wearing contact lenses, chest tightness, nausea, dizziness and dermatitis. Symptoms experienced by 50 doctors and 50 paramedical personnel working in an air-conditioned intensive care unit and operating theatres of the Government Rajaji Hospital, Madurai in India were studied by means of a questionnaire survey. In the present study, respiratory and ocular symptoms were observed more in those working in operating theatres and were believed to be due to excessive use of formaldehyde used for sterilization. Various suggestions were made to prevent sick building syndrome. Moreover, the physicians treating sick individuals should be aware of the symptoms caused by indoor air pollutants as sufferers invariably require a change of environment rather than drugs. (orig.).

  20. Does smoking affect the outcomes of lumbar decompression surgery?

    Directory of Open Access Journals (Sweden)

    Mehta Radha


    Full Text Available Introduction: Lumbar decompressions and micro-discectomies are commonly performed non-complex spinal surgeries that do not involve the insertion of metalwork into the spine and are done for symptomatic disc prolapse and lumbar spinal stenosis, whereas complex-spinal surgery does require metalwork [1]. Studies of complex-spinal surgeries show that smoking has a significant negative impact on the outcome of the surgery [2] therefore, the cessation of smoking is advised prior to surgery [3]. There are evidences in the literature supportive as well as opposing this statement about continued smoking and poor outcome of decompressive spinal surgeries. Methods: We retrospectively reviewed 143 consecutive patients who have had either a micro-discectomy or a micro-decompression. Results: We found no statistical difference between smokers and non-smokers in the outcomes of lumbar decompression surgery. Both groups improved equally and significantly in terms of back pain, leg pain and functions. Out of 143 patients, only 2% more non-smokers had improved leg pain compared to smokers, 1% less non-smokers had improved back pain and 2% more non-smokers had an improved Oswestry Disability Index (ODI score. Discussion: We recommend that it is important to surgically treat both smokers and non-smokers in need of a lumbar spinal decompression.

  1. Failure rate of prehospital chest decompression after severe thoracic trauma. (United States)

    Kaserer, Alexander; Stein, Philipp; Simmen, Hans-Peter; Spahn, Donat R; Neuhaus, Valentin


    Chest decompression can be performed by different techniques, like needle thoracocentesis (NT), lateral thoracostomy (LT), or tube thoracostomy (TT). The aim of this study was to report the incidence of prehospital chest decompression and to analyse the effectiveness of these techniques. In this retrospective case series study, all medical records of adult trauma patients undergoing prehospital chest decompression and admitted to the resuscitation area of a level-1 trauma center between 2009 and 2015 were reviewed and analysed. Only descriptive statistics were applied. In a 6-year period 24 of 2261 (1.1%) trauma patients had prehospital chest decompression. Seventeen patients had NT, six patients TT, one patient NT as well as TT, and no patients had LT. Prehospital successful release of a tension pneumothorax was reported by the paramedics in 83% (5/6) with TT, whereas NT was effective in 18% only (3/17). In five CT scans all thoracocentesis needles were either removed or extrapleural, one patient had a tension pneumothorax, and two patients had no pneumothorax. No NT or TT related complications were reported during hospitalization. Prehospital NT or TT is infrequently attempted in trauma patients. Especially NT is associated with a high failure rate of more than 80%, potentially due to an inadequate ratio between chest wall thickness and catheter length as previously published as well as a possible different pathophysiological cause of respiratory distress. Therefore, TT may be considered already in the prehospital setting to retain sufficient pleural decompression upon admission. Copyright © 2016. Published by Elsevier Inc.

  2. Deadly diving? Physiological and behavioural management of decompression stress in diving mammals (United States)

    Hooker, S. K.; Fahlman, A.; Moore, M. J.; Aguilar de Soto, N.; Bernaldo de Quirós, Y.; Brubakk, A. O.; Costa, D. P.; Costidis, A. M.; Dennison, S.; Falke, K. J.; Fernandez, A.; Ferrigno, M.; Fitz-Clarke, J. R.; Garner, M. M.; Houser, D. S.; Jepson, P. D.; Ketten, D. R.; Kvadsheim, P. H.; Madsen, P. T.; Pollock, N. W.; Rotstein, D. S.; Rowles, T. K.; Simmons, S. E.; Van Bonn, W.; Weathersby, P. K.; Weise, M. J.; Williams, T. M.; Tyack, P. L.


    Decompression sickness (DCS; ‘the bends’) is a disease associated with gas uptake at pressure. The basic pathology and cause are relatively well known to human divers. Breath-hold diving marine mammals were thought to be relatively immune to DCS owing to multiple anatomical, physiological and behavioural adaptations that reduce nitrogen gas (N2) loading during dives. However, recent observations have shown that gas bubbles may form and tissue injury may occur in marine mammals under certain circumstances. Gas kinetic models based on measured time-depth profiles further suggest the potential occurrence of high blood and tissue N2 tensions. We review evidence for gas-bubble incidence in marine mammal tissues and discuss the theory behind gas loading and bubble formation. We suggest that diving mammals vary their physiological responses according to multiple stressors, and that the perspective on marine mammal diving physiology should change from simply minimizing N2 loading to management of the N2 load. This suggests several avenues for further study, ranging from the effects of gas bubbles at molecular, cellular and organ function levels, to comparative studies relating the presence/absence of gas bubbles to diving behaviour. Technological advances in imaging and remote instrumentation are likely to advance this field in coming years. PMID:22189402

  3. Clinical characteristics of subacute radiation sickness

    International Nuclear Information System (INIS)

    Jiang Benrong; Ye Genyao; Huang Shimin


    The clinical characteristics, diagnosis and differential diagnosis of subacute radiation sickness are analysed and discussed in this paper on the basis of clinical data from cases in a 137 Cs source accident in Mudanjiang and of a review of the literature. We consider that the subacute radiation sickness is a whole body disease caused by comparatively large dose of continuous or intermittent external irradiation in several weeks or months. it must be differentiated from acute radiation sickness, chronic radiation sickness, idiopathic aplastic anemia and other hematological diseases, such as paroxysmal nocturnal hemoglobinuria, acute leukemia and myelodysplastic syndrome

  4. General practitioners' use of sickness certificates. (United States)

    Roope, Richard; Parker, Gordon; Turner, Susan


    At present, sickness certification is largely undertaken by general practitioners (GPs). Guidance from the Department of Work and Pensions (DWP) is available to help with this task; however, there has been little formal evaluation of the DWP's guidance in relation to day-to-day general practice. To assess GPs' training, knowledge and application of the DWP's sickness certification guidelines. A structured questionnaire was sent to GPs within a (former) primary care trust (PCT). It probed demographics, training and knowledge of sickness certification guidelines. Case histories and structured questions were used to assess current practice. In this group of 113 GPs, there was a low awareness and use of the DWP's guidelines and Website relating to sickness certification. The majority of the GPs (63%) had received no training in sickness certification, and the mean length of time for those who had received training was 4.1 h. Most GPs also felt that patients and GPs have equal influence on the duration of sickness certification. This evidence of variable practice indicates that GPs should have more guidance and education in sickness certification. Closer sickness certification monitoring through existing GP computer systems may facilitate an improvement in practice that benefits patients and employers. The DWP, medical educators and PCTs may all have an additional role in further improving sickness certification practice.

  5. Office design's impact on sick leave rates. (United States)

    Bodin Danielsson, Christina; Chungkham, Holendro Singh; Wulff, Cornelia; Westerlund, Hugo


    The effect of office type on sickness absence among office employees was studied prospectively in 1852 employees working in (1) cell-offices; (2) shared-room offices; (3) small, (4) medium-sized and (5) large open-plan offices; (6) flex-offices and (7) combi-offices. Sick leaves were self-reported two years later as number of (a) short and (b) long (medically certified) sick leave spells as well as (c) total number of sick leave days. Multivariate logistic regression analysis was used, with adjustment for background factors. A significant excess risk for sickness absence was found only in terms of short sick leave spells in the three open-plan offices. In the gender separate analysis, this remained for women, whereas men had a significantly increased risk in flex-offices. For long sick leave spells, a significantly higher risk was found among women in large open-plan offices and for total number of sick days among men in flex-offices. A prospective study of the office environment's effect on employees is motivated by the high rates of sick leaves in the workforce. The results indicate differences between office types, depending on the number of people sharing workspace and the opportunity to exert personal control as influenced by the features that define the office types.

  6. Reasons for revision surgery after orbital decompression for Graves’ orbitopathy

    Directory of Open Access Journals (Sweden)

    Stefano Sellari-Franceschini


    Full Text Available Stefano Sellari-Franceschini1, Luca Muscatello1, Veronica Seccia1, Riccardo Lenzi1, Amelia Santoro1, Marco Nardi2, Barbara Mazzi3, Aldo Pinchera3, Claudio Marcocci31Department of Neuroscience, 1st ENT division, 2Ophthalmology Division, 3Department of Endocrinology and Metabolism, Orthopaedics and Traumatology, Occupational Medicine, University of Pisa, ItalyObjectives: An analysis of complications and causes of failure in orbital decompression necessitating a second operation.Methods: Between December 1992 and April 2007, 375 patients (719 orbits were operated on using various techniques. Fourteen patients were initially operated on in our unit: 8 (group A1 were re-operated on after a short time due to complications connected with the decompression operation, 7 (group A2 were operated on after some time due to recurrence of the illness or unsatisfactory decompression (one patient is in both group A1 and A2. Five patients (group B underwent a first operation elsewhere.Results: For group A1 the most serious complications were connected to the nasal approach. For group A2 the operations were performed either because of a neuropathy recurrence or for further proptosis reduction due to recurrence or patient dissatisfaction. Lack of preoperative data hinders conclusions about group B, apart from one patient where the operation had not resolved a serious optic neuropathy after decompression based on Olivari technique combined with three-wall operation according to Mourits and colleagues (1990.Conclusions: We can deduce from group A1 that extreme attention is necessary during endonasal access, from group A2 that balancing the eyes is advisable, sacrificing maximum proptosis reduction to gain greater patient satisfaction, and from group B that decompression of the orbital apex is fundamental in the case of neuropathy.Keywords: orbital decompression, Graves’ orbitopathy, revision surgery

  7. The incidence of diplopia following coronal and translid orbital decompression in Graves' orbitopathy

    NARCIS (Netherlands)

    Paridaens, D.; Hans, K.; van Buitenen, S.; Mourits, M. P.


    PURPOSE: Firstly, to assess the incidence of induced diplopia following orbital decompression in patients with Graves' orbitopathy. Secondly, to assess patient satisfaction after orbital decompression. Thirdly, to determine the factors that contribute to the variable reported incidence of diplopia

  8. Superior vena caval obstruction - decompression with chemotherapy and subsequent irradiation

    International Nuclear Information System (INIS)

    Kolaric, K.; Maricic, Z.; Dujmovic, I.; Mrsic, Z.


    The clinical picture, pathogenesis and etiology of malignant vena caval obstruction are described. The importance of using modern methods to treat this critical condition is emphasized. Furthermore, the authors examine the principles of chemotherapeutic decompression followed by irradiation. A single dose of nitrogen mustard was applied intravenously, followed by irradiation, on 24 patients with malignant vena caval obstruction. The results of this treatment are presented. The effect of this treatment was controlled by measuring the venous blood pressure and with chest X-rays. The authors conclude, that this method of decompression is successful in the palliative treatment of this syndrom. (orig.) [de

  9. sick: The Spectroscopic Inference Crank (United States)

    Casey, Andrew R.


    There exists an inordinate amount of spectral data in both public and private astronomical archives that remain severely under-utilized. The lack of reliable open-source tools for analyzing large volumes of spectra contributes to this situation, which is poised to worsen as large surveys successively release orders of magnitude more spectra. In this article I introduce sick, the spectroscopic inference crank, a flexible and fast Bayesian tool for inferring astrophysical parameters from spectra. sick is agnostic to the wavelength coverage, resolving power, or general data format, allowing any user to easily construct a generative model for their data, regardless of its source. sick can be used to provide a nearest-neighbor estimate of model parameters, a numerically optimized point estimate, or full Markov Chain Monte Carlo sampling of the posterior probability distributions. This generality empowers any astronomer to capitalize on the plethora of published synthetic and observed spectra, and make precise inferences for a host of astrophysical (and nuisance) quantities. Model intensities can be reliably approximated from existing grids of synthetic or observed spectra using linear multi-dimensional interpolation, or a Cannon-based model. Additional phenomena that transform the data (e.g., redshift, rotational broadening, continuum, spectral resolution) are incorporated as free parameters and can be marginalized away. Outlier pixels (e.g., cosmic rays or poorly modeled regimes) can be treated with a Gaussian mixture model, and a noise model is included to account for systematically underestimated variance. Combining these phenomena into a scalar-justified, quantitative model permits precise inferences with credible uncertainties on noisy data. I describe the common model features, the implementation details, and the default behavior, which is balanced to be suitable for most astronomical applications. Using a forward model on low-resolution, high signal


    Energy Technology Data Exchange (ETDEWEB)

    Casey, Andrew R., E-mail: [Institute of Astronomy, University of Cambridge, Madingley Road, Cambdridge, CB3 0HA (United Kingdom)


    There exists an inordinate amount of spectral data in both public and private astronomical archives that remain severely under-utilized. The lack of reliable open-source tools for analyzing large volumes of spectra contributes to this situation, which is poised to worsen as large surveys successively release orders of magnitude more spectra. In this article I introduce sick, the spectroscopic inference crank, a flexible and fast Bayesian tool for inferring astrophysical parameters from spectra. sick is agnostic to the wavelength coverage, resolving power, or general data format, allowing any user to easily construct a generative model for their data, regardless of its source. sick can be used to provide a nearest-neighbor estimate of model parameters, a numerically optimized point estimate, or full Markov Chain Monte Carlo sampling of the posterior probability distributions. This generality empowers any astronomer to capitalize on the plethora of published synthetic and observed spectra, and make precise inferences for a host of astrophysical (and nuisance) quantities. Model intensities can be reliably approximated from existing grids of synthetic or observed spectra using linear multi-dimensional interpolation, or a Cannon-based model. Additional phenomena that transform the data (e.g., redshift, rotational broadening, continuum, spectral resolution) are incorporated as free parameters and can be marginalized away. Outlier pixels (e.g., cosmic rays or poorly modeled regimes) can be treated with a Gaussian mixture model, and a noise model is included to account for systematically underestimated variance. Combining these phenomena into a scalar-justified, quantitative model permits precise inferences with credible uncertainties on noisy data. I describe the common model features, the implementation details, and the default behavior, which is balanced to be suitable for most astronomical applications. Using a forward model on low-resolution, high signal


    International Nuclear Information System (INIS)

    Casey, Andrew R.


    There exists an inordinate amount of spectral data in both public and private astronomical archives that remain severely under-utilized. The lack of reliable open-source tools for analyzing large volumes of spectra contributes to this situation, which is poised to worsen as large surveys successively release orders of magnitude more spectra. In this article I introduce sick, the spectroscopic inference crank, a flexible and fast Bayesian tool for inferring astrophysical parameters from spectra. sick is agnostic to the wavelength coverage, resolving power, or general data format, allowing any user to easily construct a generative model for their data, regardless of its source. sick can be used to provide a nearest-neighbor estimate of model parameters, a numerically optimized point estimate, or full Markov Chain Monte Carlo sampling of the posterior probability distributions. This generality empowers any astronomer to capitalize on the plethora of published synthetic and observed spectra, and make precise inferences for a host of astrophysical (and nuisance) quantities. Model intensities can be reliably approximated from existing grids of synthetic or observed spectra using linear multi-dimensional interpolation, or a Cannon-based model. Additional phenomena that transform the data (e.g., redshift, rotational broadening, continuum, spectral resolution) are incorporated as free parameters and can be marginalized away. Outlier pixels (e.g., cosmic rays or poorly modeled regimes) can be treated with a Gaussian mixture model, and a noise model is included to account for systematically underestimated variance. Combining these phenomena into a scalar-justified, quantitative model permits precise inferences with credible uncertainties on noisy data. I describe the common model features, the implementation details, and the default behavior, which is balanced to be suitable for most astronomical applications. Using a forward model on low-resolution, high signal

  12. Eruptive dynamics during magma decompression: a laboratory approach (United States)

    Spina, L.; Cimarelli, C.; Scheu, B.; Wadsworth, F.; Dingwell, D. B.


    A variety of eruptive styles characterizes the activity of a given volcano. Indeed, eruptive styles can range from effusive phenomena to explosive eruptions, with related implications for hazard management. Rapid changes in eruptive style can occur during an ongoing eruption. These changes are, amongst other, related to variations in the magma ascent rate, a key parameter affecting the eruptive style. Ascent rate is in turn dependent on several factors such as the pressure in the magma chamber, the physical properties of the magma and the rate at which these properties change. According to the high number of involved parameters, laboratory decompression experiments are the best way to achieve quantitative information on the interplay of each of those factors and the related impact on the eruption style, i.e. by analyzing the flow and deformation behavior of the transparent volatile-bearing analogue fluid. We carried out decompression experiments following different decompression paths and using silicone oil as an analogue for the melt, with which we can simulate a range of melt viscosity values. For a set of experiments we added rigid particles to simulate the presence of crystals in the magma. The pure liquid or suspension was mounted into a transparent autoclave and pressurized to different final pressures. Then the sample was saturated with argon for a fixed amount of time. The decompression path consists of a slow decompression from the initial pressure to the atmospheric condition. Alternatively, samples were decompressed almost instantaneously, after established steps of slow decompression. The decompression path was monitored with pressure transducers and a high-speed video camera. Image analysis of the videos gives quantitative information on the bubble distribution with respect to depth in the liquid, pressure and time of nucleation and on their characteristics and behavior during the ongoing magma ascent. Furthermore, we also monitored the evolution of

  13. Indoor air pollution and sick building syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Robertson, J P


    The topics discussed in this paper are accept that SBS (Sick building syndrome) is a reality ; understand the dimensions of the problem ; differentiate between sick building syndrome and building related illness ; introduce standards ; understanding the economics ; act pro-actively not re-actively.


    Directory of Open Access Journals (Sweden)

    A. A. Chernova


    Full Text Available Published data demonstrating genetic determination of sick sinus syndrome is presented. The definition of this pathology is presented; the main symptoms are described, as well as genes that influence the development of idiopathic sick sinus syndrome, their polymorphisms and role in disorders of the cardiovascular system.

  15. Indoor air pollution and sick building syndrome

    International Nuclear Information System (INIS)

    Robertson, J.P.


    The topics discussed in this paper are accept that SBS (Sick building syndrome) is a reality ; understand the dimensions of the problem ; differentiate between sick building syndrome and building related illness ; introduce standards ; understanding the economics ; act pro-actively not re-actively

  16. Job demands, health perception and sickness absence

    NARCIS (Netherlands)

    Roelen, C.A.; Koopmans, P.C.; de Graaf, J.H.; van Zandbergen, J.W.; Groothoff, J.W.


    Background Investigation of the relations between job demands, health and sickness absence is required to design a strategy for the prevention of absence and disability. Aim To study the relationships between (physical and psychological) job demands, health perception and sickness absence. Methods

  17. Transnasal Endoscopic Optic Nerve Decompression in Post Traumatic Optic Neuropathy. (United States)

    Gupta, Devang; Gadodia, Monica


    To quantify the successful outcome in patients following optic nerve decompression in post traumatic unilateral optic neuropathy in form of improvement in visual acuity. A prospective study was carried out over a period of 5 years (January 2011 to June 2016) at civil hospital Ahmedabad. Total 20 patients were selected with optic neuropathy including patients with direct and indirect trauma to unilateral optic nerve, not responding to conservative management, leading to optic neuropathy and subsequent impairment in vision and blindness. Decompression was done via Transnasal-Ethmo-sphenoidal route and outcome was assessed in form of post-operative visual acuity improvement at 1 month, 6 months and 1 year follow up. After surgical decompression complete recovery of visual acuity was achieved in 16 (80%) patients and partial recovery in 4 (20%). Endoscopic transnasal approach is beneficial in traumatic optic neuropathy not responding to steroid therapy and can prevent permanent disability if earlier intervention is done prior to irreversible damage to the nerve. Endoscopic optic nerve surgery can decompress the traumatic and oedematous optic nerve with proper exposure of orbital apex and optic canal without any major intracranial, intraorbital and transnasal complications.

  18. Decompressive craniectomy and hydrocephalus: proposal of a therapeutic flow chart. (United States)

    Peraio, Simone; Calcagni, Maria Lucia; Mattoli, Maria Vittoria; Marziali, Giammaria; DE Bonis, Pasquale; Pompucci, Angelo; Anile, Carmelo; Mangiola, Annunziato


    Decompressive craniectomy (DC) may be necessary to save the lives of patients suffering from intracranial hypertension. However, this procedure is not complication-free. Its two main complications are hydrocephalus and the sinking skin-flap syndrome (SSFS). The radiological findings and the clinical evaluation may be not enough to decide when and/or how to treat hydrocephalus in a decompressed patient. SSFS and hydrocephalus may be not unrelated. In fact, a patient affected by hydrocephalus, after the ventriculo-peritoneal shunt, can develop SSFS; on the other hand, SSFS per se can cause hydrocephalus. Treating hydrocephalus in decompressed patients can be challenging. Radiological findings and clinical evaluation may not be enough to define the most appropriate therapeutic strategy. Cerebrospinal fluid (CSF) dynamics and metabolic evaluations can represent important diagnostic tools for assessing the need of a CSF shunt in patients with a poor baseline neurologic status. Based on our experience, we propose a flow chart for treating decompressed patients affected by ventriculomegaly.

  19. Examining paid sickness absence by shift workers. (United States)

    Catano, V M; Bissonnette, A B


    Shift workers are at greater risk than day workers with respect to psychological and physical health, yet little research has linked shift work to increased sickness absence. To investigate the relationship between shift work and sickness absence while controlling for organizational and individual characteristics and shift work attributes that have confounded previous research. The study used archive data collected from three national surveys in Canada, each involving over 20000 employees and 6000 private-sector firms in 14 different occupational groups. The employees reported the number of paid sickness absence days in the past 12 months. Data were analysed using both chi-squared statistics and hierarchical regressions. Contrary to previous research, shift workers took less paid sickness absence than day workers. There were no differences in the length of the sickness absence between both groups or in sickness absence taken by female and male workers whether working days or shifts. Only job tenure, the presence of a union in the workplace and working rotating shifts predicted sickness absence in shift workers. The results were consistent across all three samples. In general, shift work does not seem to be linked to increased sickness absence. However, such associations may be true for specific industries. Male and female workers did not differ in the amount of sickness absence taken. Rotating shifts, regardless of industry, predicted sickness absence among shift workers. Consideration should be given to implementing scheduled time off between shift changes. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email:

  20. Archives, libraries and museums: containers often sick, sometimes seriously sick

    Directory of Open Access Journals (Sweden)

    Roberto Nicolucci


    Full Text Available As far as the feeling of quietness and peace that they often convey, archives, museums and libraries also hide dangers that you may not imagine, either for visitors or especially for the members of the staff. Indeed the poor microclimatic conditions – often the consequences of materials and construction or building technologies that appear definitely obsolete – often arouse suspicion and worry among the staff. Wrong Thermo hygrometric parameters, the presence of volatile organic elements, mineral fibers, biocides, radon gas, aerial dispersive molecules, are among others some of the chemical physical polluters of major influence that may contribute to giving life to the so-called Sick Building Syndrome. But such spaces also bear biological polluters that can provoke pathologies of various types and importance, among which the feared Illness of Legionnaire. The presence of electromagnetic fields, but above all wrong lighting and wrong ergonomic working positions represent some risk factors for members of staff and visitors.

  1. Pharmacological versus microvascular decompression approaches for the treatment of trigeminal neuralgia: clinical outcomes and direct costs

    Directory of Open Access Journals (Sweden)

    Almeida A


    Full Text Available Laurinda Lemos1,2, Carlos Alegria3, Joana Oliveira3, Ana Machado2, Pedro Oliveira4, Armando Almeida11Life and Health Sciences Research Institute (ICVS, School of Health Sciences, Campus de Gualtar, University of Minho, Braga, Portugal; 2Hospital Center of Alto Ave, Unit of Fafe, Fafe, Portugal; 3Department of Neurosurgery, Hospital São Marcos; 4Products and Systems Engineering, Campus de Azurém, University of Minho, Guimarães, PortugalAbstract: In idiopathic trigeminal neuralgia (TN the neuroimaging evaluation is usually normal, but in some cases a vascular compression of trigeminal nerve root is present. Although the latter condition may be referred to surgery, drug therapy is usually the first approach to control pain. This study compared the clinical outcome and direct costs of (1 a traditional treatment (carbamazepine [CBZ] in monotherapy [CBZ protocol], (2 the association of gabapentin (GBP and analgesic block of trigger-points with ropivacaine (ROP (GBP+ROP protocol, and (3 a common TN surgery, microvascular decompression of the trigeminal nerve (MVD protocol. Sixty-two TN patients were randomly treated during 4 weeks (CBZ [n = 23] and GBP+ROP [n = 17] protocols from cases of idiopathic TN, or selected for MVD surgery (n = 22 due to intractable pain. Direct medical cost estimates were determined by the price of drugs in 2008 and the hospital costs. Pain was evaluated using the Numerical Rating Scale (NRS and number of pain crises; the Hospital Anxiety and Depression Scale, Sickness Impact Profile, and satisfaction with treatment and hospital team were evaluated. Assessments were performed at day 0 and 6 months after the beginning of treatment. All protocols showed a clinical improvement of pain control at month 6. The GBP+ROP protocol was the least expensive treatment, whereas surgery was the most expensive. With time, however, GBP+ROP tended to be the most and MVD the least expensive. No sequelae resulted in any patient after drug

  2. Original endoscopic orbital decompression of lateral wall through hairline approach for Graves’ ophthalmopathy: an innovation of balanced orbital decompression

    Directory of Open Access Journals (Sweden)

    Gong Y


    Full Text Available Yi Gong,1,* Jiayang Yin,2,* Boding Tong,2 Jingkun Li,3 Jiexi Zeng,2 Zhongkun Zuo,1 Fei Ye,1 Yongheng Luo,4 Jing Xiao,1 Wei Xiong2 1Department of Minimal Invasive Surgery, The Second Xiangya Hospital, Central South University, Changsha, China; 2Department of Ophthalmology and Eye Research Center, The Second Xiangya Hospital, Central South University, Changsha, China; 3E.N.T Department, The Second Xiangya Hospital, Central South University, Changsha, China; 4Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China *These authors contributed equally to this work Background: Orbital decompression is an important surgical procedure for treatment of Graves’ ophthalmopathy (GO, especially in women. It is reasonable for balanced orbital decompression of the lateral and medial wall. Various surgical approaches, including endoscopic transnasal surgery for medial wall and eye-side skin incision surgery for lateral wall, are being used nowadays, but many of them lack the validity, safety, or cosmetic effect. Patients and methods: Endoscopic orbital decompression of lateral wall through hairline approach and decompression of medial wall via endoscopic transnasal surgery was done to achieve a balanced orbital decompression, aiming to improve the appearance of proptosis and create conditions for possible strabismus and eyelid surgery afterward. From January 29, 2016 to February 14, 2017, this surgery was performed on 41 orbits in 38 patients with GO, all of which were at inactive stage of disease. Just before surgery and at least 3 months after surgery, Hertel’s ophthalmostatometer and computed tomography (CT were used to check proptosis and questionnaires of GO quality of life (QOL were completed. Findings: The postoperative retroversion of eyeball was 4.18±1.11 mm (Hertel’s ophthalmostatometer and 4.17±1.14 mm (CT method. The patients’ QOL was significantly improved, especially the change in appearance without

  3. Acute high-altitude sickness

    Directory of Open Access Journals (Sweden)

    Andrew M. Luks


    Full Text Available At any point 1–5 days following ascent to altitudes ≥2500 m, individuals are at risk of developing one of three forms of acute altitude illness: acute mountain sickness, a syndrome of nonspecific symptoms including headache, lassitude, dizziness and nausea; high-altitude cerebral oedema, a potentially fatal illness characterised by ataxia, decreased consciousness and characteristic changes on magnetic resonance imaging; and high-altitude pulmonary oedema, a noncardiogenic form of pulmonary oedema resulting from excessive hypoxic pulmonary vasoconstriction which can be fatal if not recognised and treated promptly. This review provides detailed information about each of these important clinical entities. After reviewing the clinical features, epidemiology and current understanding of the pathophysiology of each disorder, we describe the current pharmacological and nonpharmacological approaches to the prevention and treatment of these diseases.

  4. Workplace bullying and sickness presenteeism

    DEFF Research Database (Denmark)

    Conway, Paul Maurice; Clausen, Thomas; Hansen, Åse Marie


    Purpose: The aim of this study is to investigate exposure to workplace bullying as a potential risk factor for sickness presenteeism (SP), i.e., working while ill. Methods: This study is based on data collected through self-reported questionnaires in a 2-year prospective study on employees...... with missing values, the final samples were composed of 2,865 and 1,331participants in the cross-sectional and prospective analyses, respectively. Results: Modified poisson regression analyses showed that frequent (i.e., daily or weekly) exposure to workplace bullying was associated with reporting 8 or more...... indications of a significant relationship between exposure to frequent workplace bullying and SP, although causal connections could not be established. Methodological and theoretical considerations about study findings are provided, which could be of benefit to future studies examining the impact of being...

  5. Motion sickness: a negative reinforcement model. (United States)

    Bowins, Brad


    Theories pertaining to the "why" of motion sickness are in short supply relative to those detailing the "how." Considering the profoundly disturbing and dysfunctional symptoms of motion sickness, it is difficult to conceive of why this condition is so strongly biologically based in humans and most other mammalian and primate species. It is posited that motion sickness evolved as a potent negative reinforcement system designed to terminate motion involving sensory conflict or postural instability. During our evolution and that of many other species, motion of this type would have impaired evolutionary fitness via injury and/or signaling weakness and vulnerability to predators. The symptoms of motion sickness strongly motivate the individual to terminate the offending motion by early avoidance, cessation of movement, or removal of oneself from the source. The motion sickness negative reinforcement mechanism functions much like pain to strongly motivate evolutionary fitness preserving behavior. Alternative why theories focusing on the elimination of neurotoxins and the discouragement of motion programs yielding vestibular conflict suffer from several problems, foremost that neither can account for the rarity of motion sickness in infants and toddlers. The negative reinforcement model proposed here readily accounts for the absence of motion sickness in infants and toddlers, in that providing strong motivation to terminate aberrant motion does not make sense until a child is old enough to act on this motivation.

  6. System for analysing sickness absenteeism in Poland. (United States)

    Indulski, J A; Szubert, Z


    The National System of Sickness Absenteeism Statistics has been functioning in Poland since 1977, as the part of the national health statistics. The system is based on a 15-percent random sample of copies of certificates of temporary incapacity for work issued by all health care units and authorised private medical practitioners. A certificate of temporary incapacity for work is received by every insured employee who is compelled to stop working due to sickness, accident, or due to the necessity to care for a sick member of his/her family. The certificate is required on the first day of sickness. Analyses of disease- and accident-related sickness absenteeism carried out each year in Poland within the statistical system lead to the main conclusions: 1. Diseases of the musculoskeletal and peripheral nervous systems accounting, when combined, for 1/3 of the total sickness absenteeism, are a major health problem of the working population in Poland. During the past five years, incapacity for work caused by these diseases in males increased 2.5 times. 2. Circulatory diseases, and arterial hypertension and ischaemic heart disease in particular (41% and 27% of sickness days, respectively), create an essential health problem among males at productive age, especially, in the 40 and older age group. Absenteeism due to these diseases has increased in males more than two times.

  7. Explaining the gender gap in sickness absence. (United States)

    Østby, K A; Mykletun, A; Nilsen, W


    In many western countries, women have a much higher rate of sickness absence than men. To what degree the gender differences in sickness absence are caused by gender differences in health is largely unknown. To assess to what degree the gender gap in sickness absence can be explained by health factors and work- and family-related stressors. Norwegian parents participating in the Tracking Opportunities and Problems (TOPP) study were asked about sickness absence and a range of factors possibly contributing to gender differences in sickness absence, including somatic and mental health, sleep problems, job control/demands, work-home conflicts, parent-child conflicts and stressful life events. Using a cross-sectional design, we did linear regression analyses, to assess the relative contribution from health and stressors. There were 557 study participants. Adjusting for health factors reduced the gender difference in sickness absence by 24%, while adjusting for stressors in the family and at work reduced the difference by 22%. A simultaneous adjustment for health factors and stressors reduced the difference in sickness absence by about 28%. Despite adjusting for a large number of factors, including both previously well-studied factors (e.g. health, job control/demands) and lesser-studied factors (parent-child conflict and sexual assault), this study found that most of the gender gap in sickness absence remains unexplained. Gender differences in health and stressors account for only part of the differences in sickness absence. Other factors must, therefore, exist outside the domains of health, work and family stressors.

  8. Decompression Sickness and U-2 Operations: Summary of Research, Findings, and Recommendations Regarding Use of Exercise During Prebreathe (United States)


    Research Laboratory Hypobaric DCS Research Database developed at Brooks AFB, TX, which has detailed information on over 3,000 research chamber... hyperbaric oxygen therapy resulting in complete resolution of all symptoms. After instituting EDP, the same pilot flew 36 U-2 high flights without any...consultation with base SGP and USAFSAM Hyperbarics and MAJCOM/SGPA. Earlier guidance in the 1980’s was much more restrictive and, in fact, permanently

  9. Predictors of sickness absence in pregnancy

    DEFF Research Database (Denmark)

    Hansen, Mette Lausten; Thulstrup, Ane Marie; Juhl, Mette


    OBJECTIVE: The aim of this cohort study was to investigate associations between parity, pre-pregnancy body mass index (BMI), assisted reproductive therapy (ART), time to pregnancy (TTP), and engagement in physical exercise and the risk of sickness absence in pregnancy from 10-29 completed pregnancy...... with higher HR of sickness absence. Physical exercise of >120 minutes per week was associated with lower HR 0.84 (95% CI 0.75-0.95). CONCLUSION: Risk for sickness absence was higher among women who were multiparous, overweight, obese, received ART, and had prolonged TTP, and lower among women engaged...

  10. Healthy change processes - Relations with job insecurity, sickness absenteeism, sickness presenteeism and turnover intention


    Bødal, Åshild


    The aim of this study was to investigate whether the presence of a healthy change process (HCPI) could predict negative outcomes that normally follow organisational change, such as qualitative job insecurity, total sickness (sickness absenteeism and -presenteesim) and turnover intention. It was hypothesised that negative relationships existed between a healthy change process and qualitative job insecurity, total sickness and turnover intention. In addition, it was believed that experienced st...

  11. When healthcare workers get sick: exploring sickness absenteeism in British Columbia, Canada. (United States)

    Gorman, Erin; Yu, Shicheng; Alamgir, Hasanat


    To determine the demographic and work characteristics of healthcare workers who were more likely to take sickness absences from work in British Columbia, Canada. Payroll data were analyzed for three health regions. Sickness absence rates were determined per person-year and then compared across demographic and work characteristics using multivariate Poisson regression models. The direct costs to the employer due to sickness absences were also estimated. Female, older, full-time workers, long-term care workers and those with a lower hourly wage were more likely to take sickness absences and had similar trends with respect to the costs due to sickness absence. For occupations, licensed practical nurses, care aides and facility support workers had higher rates of sickness absence. Registered nurses, and those workers paid high hourly wages were associated with highest sickness related costs. It is important to understand the demographic and work characteristics of those workers who are more likely to take sickness absences in order to make sure that they are not experiencing additional hazards at work or facing detrimental workplace conditions. Policy makers need to establish healthy, safe and in turn more productive workplaces. Further research is needed on how interventions can reduce sickness absence.

  12. Report on computation of repetitive hyperbaric-hypobaric decompression tables (United States)

    Edel, P. O.


    The tables were constructed specifically for NASA's simulated weightlessness training program; they provide for 8 depth ranges covering depths from 7 to 47 FSW, with exposure times of 15 to 360 minutes. These tables were based up on an 8 compartment model using tissue half-time values of 5 to 360 minutes and Workmanline M-values for control of the decompression obligation resulting from hyperbaric exposures. Supersaturation ratios of 1.55:1 to 2:1 were used for control of ascents to altitude following such repetitive dives. Adequacy of the method and the resultant tables were determined in light of past experience with decompression involving hyperbaric-hypobaric interfaces in human exposures. Using these criteria, the method showed conformity with empirically determined values. In areas where a discrepancy existed, the tables would err in the direction of safety.

  13. Natural gas decompression energy recovery: Energy savings potential in Italy

    International Nuclear Information System (INIS)

    Piatti, A.; Piemonte, C.; Rampini, E.; Vatrano, F.; Techint SpA, Milan; ENEA, Rome


    This paper surveyed the natural gas distribution systems employed in the Italian civil, industrial and thermoelectric sectors to identify those installations which can make use of gas decompression energy recovery systems (consisting of turbo-expanders or alternative expanders) to economically generate electric power. Estimates were then made of the total amount of potential energy savings. The study considered as eligible for energy savings interventions only those plants with a greater than 5,000 standard cubic meter per hour plant capacity. It was evaluated that, with suitable decompression equipment installed at 50 key installations (33 civil, 15 industrial), about 200 GWh of power could be produced annually, representing potential savings of about 22,000 petroleum equivalent tonnes of energy. A comparative analysis was done on three investment alternatives involving inputs of varying amounts of Government financial assistance

  14. Decompression syndrome (Caisson disease) in an Indian diver. (United States)

    Phatak, Uday A; David, Eric J; Kulkarni, Pravin M


    Acute decompression syndrome (Caisson's disease) is an acute neurological emergency in divers. It is caused due to release of nitrogen gas bubbles that impinge the blood vessels of the spinal cord and brain and result in severe neurodeficit. There are very few case reports in Indian literature. There are multiple factors in the pathogenesis of Acute decompression syndrome (Caisson's disease) such as health problems in divers (respiratory problems or congenital heart diseases like atrial septal defect, patent ductus arteriosus etc), speed of ascent from the depth and habits like smoking that render divers susceptible for such neurological emergency. Usually, immediate diagnosis of such a condition with MRI is not possible in hospitals in the Coastal border. Even though, MRI is performed, it has very low specificity and sensitivity. Facilities like hyperbaric oxygen treatment are virtually non-existent in these hospitals. Therefore, proper education of the divers and appropriate preventive measures in professional or recreational divers is recommended.

  15. [Orbital decompression in Grave's disease: comparison of techniques]. (United States)

    Sellari-Franceschini, S; Berrettini, S; Forli, F; Bartalena, L; Marcocci, C; Tanda, M L; Nardi, M; Lepri, A; Pinchera, A


    Grave's ophthalmopathy is an inflammatory, autoimmune disorder often associated with Grave's disease. The inflammatory infiltration involves the retrobulbar fatty tissue and the extrinsic eye muscles, causing proptosis, extraocular muscle dysfunction and often diplopia. Orbital decompression is an effective treatment in such cases, particularly when resistant to drugs and external radiation therapy. This work compares the results of orbital decompression performed by removing: a) the medial and lateral walls (Mourits technique) in 10 patients (19 orbits) and b) the medial and lower walls (Walsh-Ogura technique) in 17 patients (31 orbits). The results show that removing the floor of the orbit enables better reduction of proptosis but more easily leads to post-operative diplopia. Thus it proves necessary to combine the two techniques, modifying the surgical approach on a case-by-case basis.

  16. General Automatic Components of Motion Sickness (United States)

    Suter, S.; Toscano, W. B.; Kamiya, J.; Naifeh, K.


    A body of investigations performed in support of experiments aboard the space shuttle, and designed to counteract the symptoms of Space Adaptation Syndrome, which resemble those of motion sickness on Earth is reviewed. For these supporting studies, the automatic manifestations of earth-based motion sickness was examined. Heart rate, respiration rate, finger pulse volume and basal skin resistance were measured on 127 men and women before, during and after exposure to nauseogenic rotating chair tests. Significant changes in all autonomic responses were observed across the tests. Significant differences in autonomic responses among groups divided according to motion sickness susceptibility were also observed. Results suggest that the examination of autonomic responses as an objective indicator of motion sickness malaise is warranted and may contribute to the overall understanding of the syndrome on Earth and in Space.

  17. Sick of inequality: gender and support for paid sick days. (United States)

    Lindemann, Danielle J; Houser, Linda; White, Karen


    The availability of paid sick days (PSD) is on the forefront of policy issues relating to women's health and well-being. Previous research regarding PSD and other forms of family-work balance legislation has linked access to paid time off from work for addressing one's own or another's health concerns to a range of health benefits for working women and their families. In general, public support for such policies is high, but little work has tested the extent to which support extends to PSD. Researchers have yet to engage in a rigorous statistical analysis of public opinion on PSD, including whether opinion varies by gender. Using data from a 2013 poll of adults in New Jersey (n = 925), we bridged this research gap by conducting the first multivariate analysis of public attitudes toward PSD. As expected, we found markedly high levels of support for PSD across all respondents, with a preponderance of most sociodemographic categories supporting proposed PSD legislation in New Jersey. We also found that gender was a strong predictor of support for PSD, with women significantly (odds ratio, 1.916; p ≤ .01) more likely than men to be in favor of such legislation. We discuss the implications of our findings for future work on PSD as well as for research concerning women, wellness, and work-life legislation more broadly. Published by Elsevier Inc.

  18. Immediate pain relief by microvascular decompression for idiopathic trigeminal neuralagia

    International Nuclear Information System (INIS)

    Haq, N.U.; Ali, M.; Khan, H.M.; Ishaq, M.; Khattak, M.I.


    Background: Trigeminal neuralgia is a common entity which is managed by neurosurgeons in day to day practice. Up-till now many treatment options have been adopted for it but micro-vascular decompression is much impressive in terms of pain control and recurrence rate in all of them. The objective of study was known the efficacy of micro vascular decompression for idiopathic trigeminal neuralgia by using muscle patch in terms of immediate pain relief. Methods: This descriptive study was carried out in Neurosurgery Department lady reading hospital, Peshawar from January 2010 to December 2012. All patients who underwent micro vascular decompression for idiopathic trigeminal neuralgia were included in the study. Patients were assessed 72 hours after the surgery by borrow neurological institute pain scale (BNIP scale) for pain relief and findings were documented on predesigned proforma. Data was analysed by SPSS-17. Results: Total 52 patients were included in this study. Among these 32 (61.53 percentage) were female and 20 (38.46 percentage) were males having age from 22-76 years (mean 49 years). Right side was involved in 36 (69.23 percentage) and left side in 16 (30.76 percentage) patients. Duration of symptoms ranged from 6 months to 16 years (mean 8 years). History of dental extraction and peripheral neurectomy was present in 20 (38 percentage) and 3(5.76 percentage) patients while V3 was most commonly involved branch with 28(57.69 percentage) frequency and combined V2,V3 involvement was 1 (11.53 percentage). Superior cerebellar artery was most common offending vessel in 46(88.46 percentage) while arachnoid adhesions were in 2(3.84 percentage) patients. We assessed patient immediate postoperatively using BNIP pain scale. Conclusion: Micro-vascular decompression is most effective mode of treatment for trigeminal neuralgia in terms of immediate pain relief. (author)

  19. On-the-Fly Decompression and Rendering of Multiresolution Terrain

    Energy Technology Data Exchange (ETDEWEB)

    Lindstrom, P; Cohen, J D


    We present a streaming geometry compression codec for multiresolution, uniformly-gridded, triangular terrain patches that supports very fast decompression. Our method is based on linear prediction and residual coding for lossless compression of the full-resolution data. As simplified patches on coarser levels in the hierarchy already incur some data loss, we optionally allow further quantization for more lossy compression. The quantization levels are adaptive on a per-patch basis, while still permitting seamless, adaptive tessellations of the terrain. Our geometry compression on such a hierarchy achieves compression ratios of 3:1 to 12:1. Our scheme is not only suitable for fast decompression on the CPU, but also for parallel decoding on the GPU with peak throughput over 2 billion triangles per second. Each terrain patch is independently decompressed on the fly from a variable-rate bitstream by a GPU geometry program with no branches or conditionals. Thus we can store the geometry compressed on the GPU, reducing storage and bandwidth requirements throughout the system. In our rendering approach, only compressed bitstreams and the decoded height values in the view-dependent 'cut' are explicitly stored on the GPU. Normal vectors are computed in a streaming fashion, and remaining geometry and texture coordinates, as well as mesh connectivity, are shared and re-used for all patches. We demonstrate and evaluate our algorithms on a small prototype system in which all compressed geometry fits in the GPU memory and decompression occurs on the fly every rendering frame without any cache maintenance.

  20. Nerve Decompression and Restless Legs Syndrome: A Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    James C. Anderson


    Full Text Available IntroductionRestless legs syndrome (RLS is a prevalent sleep disorder affecting quality of life and is often comorbid with other neurological diseases, including peripheral neuropathy. The mechanisms related to RLS symptoms remain unclear, and treatment options are often aimed at symptom relief rather than etiology. RLS may present in distinct phenotypes often described as “primary” vs. “secondary” RLS. Secondary RLS is often associated with peripheral neuropathy. Nerve decompression surgery of the common and superficial fibular nerves is used to treat peripheral neuropathy. Anecdotally, surgeons sometimes report improved RLS symptoms following nerve decompression for peripheral neuropathy. The purpose of this retrospective analysis was to quantify the change in symptoms commonly associated with RLS using visual analog scales (VAS.MethodsForty-two patients completed VAS scales (0–10 for pain, burning, numbness, tingling, weakness, balance, tightness, aching, pulling, cramping, twitchy/jumpy, uneasy, creepy/crawly, and throbbing, both before and 15 weeks after surgical decompression.ResultsSubjects reported significant improvement among all VAS categories, except for “pulling” (P = 0.14. The change in VAS following surgery was negatively correlated with the pre-surgery VAS for both the summed VAS (r = −0.58, P < 0.001 and the individual VAS scores (all P < 0.01, such that patients who reported the worst symptoms before surgery exhibited relatively greater reductions in symptoms after surgery.ConclusionThis is the first study to suggest improvement in RLS symptoms following surgical decompression of the common and superficial fibular nerves. Further investigation is needed to quantify improvement using RLS-specific metrics and sleep quality assessments.

  1. Motion sickness, stress and the endocannabinoid system.

    Directory of Open Access Journals (Sweden)

    Alexander Choukèr

    Full Text Available BACKGROUND: A substantial number of individuals are at risk for the development of motion sickness induced nausea and vomiting (N&V during road, air or sea travel. Motion sickness can be extremely stressful but the neurobiologic mechanisms leading to motion sickness are not clear. The endocannabinoid system (ECS represents an important neuromodulator of stress and N&V. Inhibitory effects of the ECS on N&V are mediated by endocannabinoid-receptor activation. METHODOLOGY/PRINCIPAL FINDINGS: We studied the activity of the ECS in human volunteers (n = 21 during parabolic flight maneuvers (PFs. During PFs, microgravity conditions (<10(-2 g are generated for approximately 22 s which results in a profound kinetic stimulus. Blood endocannabinoids (anandamide and 2-arachidonoylglycerol, 2-AG were measured from blood samples taken in-flight before start of the parabolic maneuvers, after 10, 20, and 30 parabolas, in-flight after termination of PFs and 24 h later. Volunteers who developed acute motion sickness (n = 7 showed significantly higher stress scores but lower endocannabinoid levels during PFs. After 20 parabolas, blood anandamide levels had dropped significantly in volunteers with motion sickness (from 0.39+/-0.40 to 0.22+/-0.25 ng/ml but increased in participants without the condition (from 0.43+/-0.23 to 0.60+/-0.38 ng/ml resulting in significantly higher anandamide levels in participants without motion sickness (p = 0.02. 2-AG levels in individuals with motion sickness were low and almost unchanged throughout the experiment but showed a robust increase in participants without motion sickness. Cannabinoid-receptor 1 (CB1 but not cannabinoid-receptor 2 (CB2 mRNA expression in leucocytes 4 h after the experiment was significantly lower in volunteers with motion sickness than in participants without N&V. CONCLUSIONS/SIGNIFICANCE: These findings demonstrate that stress and motion sickness in humans are associated with impaired endocannabinoid



    Bratberg, Espen; Monstad, Karin


    Sickness absence has risen over the past years in Norway. One explanation put forward is that a tougher labor market represents a health hazard, while a competing hypothesis predicts that loss of job security works as a disciplinary device. In this analysis we aim to trace a causal impact of organizational turmoil or job insecurity on sickness absence, applying a difference-in-difference approach. Utilizing a negative financial shock that hit specific employers and workplaces, we find that si...

  3. [Sickness absence associated with major life events]. (United States)

    Markussen, Simen; Røgeberg, Ole


    Sickness absence in the Norwegian workplace doubled in the period 1993-2003. However, the extent to which the driving factors were medical or non-medical remains unclear, as does the extent to which the cause may be found in the composition of the workforce. A differences-in-differences regression model was used to estimate the added sickness absence associated with major life events such as separation, death of spouse and pregnancy in the period 1993-2005. The data were obtained from administrative registers covering the entire Norwegian population, and include all absence periods of 16 days' duration or more reported by a doctor's medical certificate. The primary outcome measures were incidence (the proportion of absentees in a given time window) and absence (the proportion of sick days in a given time window). The level of absence among employees exposed to the specified life events was compared to control groups matched for gender, age, education and income. In 1993, people in each of the three groups exposed to major life events had more frequent and longer periods of absence than people in the control groups. This added sickness absence increased between 1993 and 2005. The changes in added sickness absence were at times significant, particularly for pregnant women. While sickness absence among pregnant women in 1993 was 15.4 percentage points higher than in the control group, the difference had increased to 24.8 percentage points in 2005. We find it improbable for the increase in added sickness absence to be caused by changes in the medical impact of life events or alterations in the workforce composition. We believe the increase is caused by changing attitudes among the working population and in the medical profession towards sickness absence on grounds that are not strictly medical, combined with improved social acceptance and diagnosis of mental health issues, and/or a medicalisation of natural health variations (pregnancy) and emotional distress (grief).

  4. Decryption-decompression of AES protected ZIP files on GPUs (United States)

    Duong, Tan Nhat; Pham, Phong Hong; Nguyen, Duc Huu; Nguyen, Thuy Thanh; Le, Hung Duc


    AES is a strong encryption system, so decryption-decompression of AES encrypted ZIP files requires very large computing power and techniques of reducing the password space. This makes implementations of techniques on common computing system not practical. In [1], we reduced the original very large password search space to a much smaller one which surely containing the correct password. Based on reduced set of passwords, in this paper, we parallel decryption, decompression and plain text recognition for encrypted ZIP files by using CUDA computing technology on graphics cards GeForce GTX295 of NVIDIA, to find out the correct password. The experimental results have shown that the speed of decrypting, decompressing, recognizing plain text and finding out the original password increases about from 45 to 180 times (depends on the number of GPUs) compared to sequential execution on the Intel Core 2 Quad Q8400 2.66 GHz. These results have demonstrated the potential applicability of GPUs in this cryptanalysis field.

  5. [Microvascular decompression for hemifacial spasm. Ten years of experience]. (United States)

    Revuelta-Gutiérrez, Rogelio; Vales-Hidalgo, Lourdes Olivia; Arvizu-Saldaña, Emiliano; Hinojosa-González, Ramón; Reyes-Moreno, Ignacio


    Hemifacial spasm characterized by involuntary paroxistic contractions of the face is more frequent on left side and in females. Evolution is progressive and in a few cases may disappear. Management includes medical treatment, botulinum toxin, and microvascular decompression of the nerve. We present the results of 116 microvascular decompressions performed in 88 patients over 10 years. All patients had previous medical treatment. All patients were operated on with microsurgical technique by asterional craniotomy. Vascular compression was present in all cases with one exception. Follow-up was from 1 month to 133 months. Were achieved excellent results in 70.45% of cases after first operation, good results in 9.09%, and poor results in 20.45% of patients. Long-term results were excellent in 81.82%, good in 6.82%, and poor in 11.36% of patients. Hypoacusia and transitory facial palsy were the main complications. Hemifacial spasm is a painless but disabling entity. Medical treatment is effective in a limited fashion. Injection of botulinum toxin has good response but benefit is transitory. Microvascular decompression is treatment of choice because it is minimally invasive, not destructive, requires minimum technical support, and yields best long-term results.

  6. Interspinous Process Decompression: Expanding Treatment Options for Lumbar Spinal Stenosis

    Directory of Open Access Journals (Sweden)

    Pierce D. Nunley


    Full Text Available Interspinous process decompression is a minimally invasive implantation procedure employing a stand-alone interspinous spacer that functions as an extension blocker to prevent compression of neural elements without direct surgical removal of tissue adjacent to the nerves. The Superion® spacer is the only FDA approved stand-alone device available in the US. It is also the only spacer approved by the CMS to be implanted in an ambulatory surgery center. We computed the within-group effect sizes from the Superion IDE trial and compared them to results extrapolated from two randomized trials of decompressive laminectomy. For the ODI, effect sizes were all very large (>1.0 for Superion and laminectomy at 2, 3, and 4 years. For ZCQ, the 2-year Superion symptom severity (1.26 and physical function (1.29 domains were very large; laminectomy effect sizes were very large (1.07 for symptom severity and large for physical function (0.80. Current projections indicate a marked increase in the number of patients with spinal stenosis. Consequently, there remains a keen interest in minimally invasive treatment options that delay or obviate the need for invasive surgical procedures, such as decompressive laminectomy or fusion. Stand-alone interspinous spacers may fill a currently unmet treatment gap in the continuum of care and help to reduce the burden of this chronic degenerative condition on the health care system.

  7. Farris-Tang retractor in optic nerve sheath decompression surgery. (United States)

    Spiegel, Jennifer A; Sokol, Jason A; Whittaker, Thomas J; Bernard, Benjamin; Farris, Bradley K


    Our purpose is to introduce the use of the Farris-Tang retractor in optic nerve sheath decompression surgery. The procedure of optic nerve sheath fenestration was reviewed at our tertiary care teaching hospital, including the use of the Farris-Tang retractor. Pseudotumor cerebri is a syndrome of increased intracranial pressure without a clear cause. Surgical treatment can be effective in cases in which medical therapy has failed and disc swelling with visual field loss progresses. Optic nerve sheath decompression surgery (ONDS) involves cutting slits or windows in the optic nerve sheath to allow cerebrospinal fluid to escape, reducing the pressure around the optic nerve. We introduce the Farris-Tang retractor, a retractor that allows for excellent visualization of the optic nerve sheath during this surgery, facilitating the fenestration of the sheath and visualization of the subsequent cerebrospinal fluid egress. Utilizing a medial conjunctival approach, the Farris-Tang retractor allows for easy retraction of the medial orbital tissue and reduces the incidence of orbital fat protrusion through Tenon's capsule. The Farris-Tang retractor allows safe, easy, and effective access to the optic nerve with good visualization in optic nerve sheath decompression surgery. This, in turn, allows for greater surgical efficiency and positive patient outcomes.

  8. Rapid decompression and desorption induced energetic failure in coal

    Directory of Open Access Journals (Sweden)

    Shugang Wang


    Full Text Available In this study, laboratory experiments are conducted to investigate the rapid decompression and desorption induced energetic failure in coal using a shock tube apparatus. Coal specimens are recovered from Colorado at a depth of 610 m. The coal specimens are saturated with the strong sorbing gas CO2 for a certain period and then the rupture disc is suddenly broken on top of the shock tube to generate a shock wave propagating upwards and a rarefaction wave propagating downwards through the specimen. This rapid decompression and desorption has the potential to cause energetic fragmentation in coal. Three types of behaviors in coal after rapid decompression are found, i.e. degassing without fragmentation, horizontal fragmentation, and vertical fragmentation. We speculate that the characteristics of fracture network (e.g. aperture, spacing, orientation and stiffness and gas desorption play a role in this dynamic event as coal can be considered as a dual porosity, dual permeability, dual stiffness sorbing medium. This study has important implications in understanding energetic failure process in underground coal mines such as coal gas outbursts.

  9. Decompression of the facial nerve in cases of hemifacial spasm

    Directory of Open Access Journals (Sweden)

    Karsten Kettel


    Full Text Available Among 11 patients a complete cure was obtained in one case, a fair result in 4 cases, while in 6 cases the effect of the operation has only been temporary and full recurrence has taken place. Even if decompression has thus resulted in a few recoveries and improvements, the results in the majority of cases have been disappointing. Everything points to hemifacial spasm being due to a disorder of the lower motor neuron. Intracranial lesions in the vicinity of the facial nerve are known to have resulted in irritation and spasm. It may be perfectly true that the majority of cases of hemifacial spasm are due to a lesion, the nature of which may vary, in the Fallopian canal near the stylomastoid foramen, not least the postparalytic following Bell's palsy. But the disappointing results of decompression seems to indicate that at the time of operation irreparable damage to the nerve has in the majority of cases been already done. Consequently I gave up decompression in cases of hemifacial spasm some years ago. Good results from injections of alcohol into the nerve have been reported13 but I prefer selective sections of the branches to the muscles involved as described by German and Greenwood8.

  10. Anterior cervical decompression and fusion with caspar plate fixation

    International Nuclear Information System (INIS)

    Rehman, L.; Akbar, H.; Das, G.; Hashim, A.S.M.


    Objective: To evaluate the role of anterior cervical decompression and fixation with Caspar plating in cervical spine injury on neurological outcome. Study Design: A case series. Place and Duration of Study: Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi, from July 2008 to March 2011. Methodology: Thirty patients admitted with cervical spine injuries were inducted in the study. All cases were evaluated for their clinical features, level of injury and degree of neurological injury was assessed using Frankel grading. Pre and postoperative record with X-rays and MRI were maintained. Cervical traction was applied to patients with sub-luxation. All patients underwent anterior cervical decompression, fusion and Caspar plate fixation. The follow-up period was 6 months with clinical and radiological assessment. Results: Among 30 patients, 24 (80%) were males and 6 (20%) were females. Age ranged from 15 to 55 years. Causes of injury were road traffic accident (n = 20), fall (n = 8) and assault (n = 2). Commonest mode of injury was road traffic accident (66.6%). Postoperative follow-up showed that pain and neurological deficit were improved in 21 patients. There was no improvement in 7 patients, one patient deteriorated and one expired. All patients developed pain at donor site. Conclusion: Anterior decompression, fusion and fixation with Caspar plate is an effective method with good neurological and radiological outcome. However, it is associated with pain at donor site. (author)

  11. Fever and sickness behavior: Friend or foe? (United States)

    Harden, L M; Kent, S; Pittman, Q J; Roth, J


    Fever has been recognized as an important symptom of disease since ancient times. For many years, fever was treated as a putative life-threatening phenomenon. More recently, it has been recognized as an important part of the body's defense mechanisms; indeed at times it has even been used as a therapeutic agent. The knowledge of the functional role of the central nervous system in the genesis of fever has greatly improved over the last decade. It is clear that the febrile process, which develops in the sick individual, is just one of many brain-controlled sickness symptoms. Not only will the sick individual appear "feverish" but they may also display a range of behavioral changes, such as anorexia, fatigue, loss of interest in usual daily activities, social withdrawal, listlessness or malaise, hyperalgesia, sleep disturbances and cognitive dysfunction, collectively termed "sickness behavior". In this review we consider the issue of whether fever and sickness behaviors are friend or foe during: a critical illness, the common cold or influenza, in pregnancy and in the newborn. Deciding whether these sickness responses are beneficial or harmful will very much shape our approach to the use of antipyretics during illness. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Relative Deprivation and Sickness Absence in Sweden

    Directory of Open Access Journals (Sweden)

    Jonas Helgertz


    Full Text Available Background: A high prevalence of sickness absence in many countries, at a substantial societal cost, underlines the importance to understand its determining mechanisms. This study focuses on the link between relative deprivation and the probability of sickness absence. Methods: 184,000 men and women in Sweden were followed between 1982 and 2001. The sample consists of working individuals between the ages of 19 and 65. The outcome is defined as experiencing more than 14 days of sickness absence during a year. Based on the complete Swedish population, an individual’s degree of relative deprivation is measured through income compared to individuals of the same age, sex, educational level and type. In accounting for the possibility that sickness absence and socioeconomic status are determined by common factors, discrete-time duration models were estimated, accounting for unobserved heterogeneity through random effects. Results: The results confirm that the failure to account for the dynamics of the individual’s career biases the influence from socioeconomic characteristics. Results consistently suggest a major influence from relative deprivation, with a consistently lower risk of sickness absence among the highly educated. Conclusions: Altering individual’s health behavior through education appears more efficient in reducing the reliance on sickness absence, rather than redistributive policies.

  13. Relative deprivation and sickness absence in Sweden. (United States)

    Helgertz, Jonas; Hess, Wolfgang; Scott, Kirk


    A high prevalence of sickness absence in many countries, at a substantial societal cost, underlines the importance to understand its determining mechanisms. This study focuses on the link between relative deprivation and the probability of sickness absence. 184,000 men and women in Sweden were followed between 1982 and 2001. The sample consists of working individuals between the ages of 19 and 65. The outcome is defined as experiencing more than 14 days of sickness absence during a year. Based on the complete Swedish population, an individual's degree of relative deprivation is measured through income compared to individuals of the same age, sex, educational level and type. In accounting for the possibility that sickness absence and socioeconomic status are determined by common factors, discrete-time duration models were estimated, accounting for unobserved heterogeneity through random effects. The results confirm that the failure to account for the dynamics of the individual's career biases the influence from socioeconomic characteristics. Results consistently suggest a major influence from relative deprivation, with a consistently lower risk of sickness absence among the highly educated. Altering individual's health behavior through education appears more efficient in reducing the reliance on sickness absence, rather than redistributive policies.

  14. Prognosis for a sick planet. (United States)

    Maslin, Mark


    Global warming is the most important science issue of the 21st century, challenging the very structure of our global society. The study of past climate has shown that the current global climate system is extremely sensitive to human-induced climate change. The burning of fossil fuels since the beginning of the industrial revolution has already caused changes with clear evidence for a 0.75 degrees C rise in global temperatures and 22 cm rise in sea level during the 20th century. The Intergovernmental Panel on Climate Change synthesis report (2007) predicts that global temperatures by 2100 could rise by between 1.1 degrees C and 6.4 degrees C. Sea level could rise by between 28 cm and 79 cm, more if the melting of the polar ice caps accelerates. In addition, weather patterns will become less predictable and the occurrence of extreme climate events, such as storms, floods, heat waves and droughts, will increase. The potential effects of global warming on human society are devastating. We do, however, already have many of the technological solutions to cure our sick planet.

  15. Intraoperative computed tomography for cervicomedullary decompression of foramen magnum stenosis in achondroplasia: two case reports. (United States)

    Arishima, Hidetaka; Tsunetoshi, Kenzo; Kodera, Toshiaki; Kitai, Ryuhei; Takeuchi, Hiroaki; Kikuta, Ken-Ichiro


    The authors report two cases of cervicomedullary decompression of foramen magnum (FM) stenosis in children with achondroplasia using intraoperative computed tomography (iCT). A 14-month-old girl with myelopathy and retarded motor development, and a 10-year-old girl who had already undergone incomplete FM decompression was presented with myelopathy. Both patients underwent decompressive sub-occipitalcraniectomy and C1 laminectomy without duraplasty using iCT. It clearly showed the extent of FM decompression during surgery, which finally enabled sufficient decompression. After the operation, their myelopathy improved. We think that iCT can provide useful information and guidance for sufficient decompression for FM stenosis in children with achondroplasia.

  16. Virtual reality sickness questionnaire (VRSQ): Motion sickness measurement index in a virtual reality environment. (United States)

    Kim, Hyun K; Park, Jaehyun; Choi, Yeongcheol; Choe, Mungyeong


    This study aims to develop a motion sickness measurement index in a virtual reality (VR) environment. The VR market is in an early stage of market formation and technological development, and thus, research on the side effects of VR devices such as simulator motion sickness is lacking. In this study, we used the simulator sickness questionnaire (SSQ), which has been traditionally used for simulator motion sickness measurement. To measure the motion sickness in a VR environment, 24 users performed target selection tasks using a VR device. The SSQ was administered immediately after each task, and the order of work was determined using the Latin square design. The existing SSQ was revised to develop a VR sickness questionnaire, which is used as the measurement index in a VR environment. In addition, the target selection method and button size were found to be significant factors that affect motion sickness in a VR environment. The results of this study are expected to be used for measuring and designing simulator sickness using VR devices in future studies. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. Frequency of decompression illness among recent and extinct mammals and "reptiles": a review (United States)

    Carlsen, Agnete Weinreich


    The frequency of decompression illness was high among the extinct marine "reptiles" and very low among the marine mammals. Signs of decompression illness are still found among turtles but whales and seals are unaffected. In humans, the risk of decompression illness is five times increased in individuals with Patent Foramen Ovale; this condition allows blood shunting from the venous circuit to the systemic circuit. This right-left shunt is characteristic of the "reptile" heart, and it is suggested that this could contribute to the high frequency of decompression illness in the extinct reptiles.

  18. Trends in Orbital Decompression Techniques of Surveyed American Society of Ophthalmic Plastic and Reconstructive Surgery Members. (United States)

    Reich, Shani S; Null, Robert C; Timoney, Peter J; Sokol, Jason A

    To assess current members of the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) regarding preference in surgical techniques for orbital decompression in Graves' disease. A 10-question web-based, anonymous survey was distributed to oculoplastic surgeons utilizing the ASOPRS listserv. The questions addressed the number of years of experience performing orbital decompression surgery, preferred surgical techniques, and whether orbital decompression was performed in collaboration with an ENT surgeon. Ninety ASOPRS members participated in the study. Most that completed the survey have performed orbital decompression surgery for >15 years. The majority of responders preferred a combined approach of floor and medial wall decompression or balanced lateral and medial wall decompression; only a minority selected a technique limited to 1 wall. Those surgeons who perform fat decompression were more likely to operate in collaboration with ENT. Most surgeons rarely remove the orbital strut, citing risk of worsening diplopia or orbital dystopia except in cases of optic nerve compression or severe proptosis. The most common reason given for performing orbital decompression was exposure keratopathy. The majority of surgeons perform the surgery without ENT involvement, and number of years of experience did not correlate significantly with collaboration with ENT. The majority of surveyed ASOPRS surgeons prefer a combined wall approach over single wall approach to initial orbital decompression. Despite the technological advances made in the field of modern endoscopic surgery, no single approach has been adopted by the ASOPRS community as the gold standard.

  19. Sick but yet at work. An empirical study of sickness presenteeism. (United States)

    Aronsson, G; Gustafsson, K; Dallner, M


    The study is an empirical investigation of sickness presenteeism in relation to occupation, irreplaceability, ill health, sickness absenteeism, personal income, and slimmed down organisation. Cross sectional design. Swedish workforce. The study group comprised a stratified subsample of 3801 employed persons working at the time of the survey, interviewed by telephone in conjunction with Statistics Sweden's labour market surveys of August and September 1997. The response rate was 87 per cent. A third of the persons in the total material reported that they had gone to work two or more times during the preceding year despite the feeling that, in the light of their perceived state of health, they should have taken sick leave. The highest presenteeism is largely to be found in the care and welfare and education sectors (nursing and midwifery professionals, registered nurses, nursing home aides, compulsory school teachers and preschool/primary educationalists. All these groups work in sectors that have faced personnel cutbacks during the 1990s). The risk ratio (odds ratio (OR)) for sickness presenteeism in the group that has to re-do work remaining after a period of absence through sickness is 2.29 (95% CI 1.79, 2.93). High proportions of persons with upper back/neck pain and fatigue/slightly depressed are among those with high presenteeism (pwork when sick. The link between difficulties in replacement or finding a stand in and sickness presenteeism is confirmed by study results. The categories with high sickness presenteeism experience symptoms more often than those without presenteeism. The most common combination is low monthly income, high sickness absenteeism and high sickness presenteeism.

  20. Changes in sickness absenteeism following the introduction of a qualifying day for sickness benefit--findings from Sweden Post

    DEFF Research Database (Denmark)

    Voss, M; Floderus, B; Diderichsen, F


    AIMS: In 1993, a qualifying day without sickness benefit was introduced to the Swedish sickness benefit system. The aim of the present study is to investigate sickness absenteeism before and after the introduction of the qualifying day, in the light of conditions inside and outside working life....... METHODS: The study was based on 1,952 female and 2,229 male employees of Sweden Post. Sickness absence was measured by sickness incidence one year before and one year after the introduction of the qualifying day (sick-leave events/person days at risk). Information about explanatory factors was collected...

  1. Attitudes towards sickness absence and sickness presenteeism in health and care sectors in Norway and Denmark: a qualitative study. (United States)

    Krane, Line; Larsen, Eva Ladekjær; Nielsen, Claus Vinther; Stapelfeldt, Christina Malmose; Johnsen, Roar; Risør, Mette Bech


    In the health and care sector, sickness absence and sickness presenteeism are frequent phenomena and constitute a field in need of exploration. Attitudes towards sickness absence involve also attitudes towards sickness presenteeism, i.e. going to work while sick, confirmed by previous studies. Sickness behavior, reflecting attitudes on work absence, could differ between countries and influence absence rates. But little is known about attitudes towards sickness absence and sickness presenteeism in the health and care sectors in Norway and Denmark. The aim of the present paper is therefore to explore attitudes towards sickness absence and sickness presenteeism among nursing home employees in both countries. Eight focus group discussions (FGDs) were conducted using a semi-structured interview guide, the main attention of which was attitudes towards sickness absence and sickness presenteeism. FGDs were conducted in two nursing homes in Norway and two in Denmark, with different geographic locations: one in a rural area and one in an urban area in each country. FGDs were recorded, transcribed and analyzed using framework analysis to identify major themes and explanatory patterns. Four major significant themes were identified from the FGDs: a) sickness absence and sickness presenteeism, b) acceptable causes of sickness absence, c) job identity, and d) organization of work and physical aspects of the workplace. Our analyses showed that social commitment and loyalty to residents and colleagues was important for sickness absence and sickness presenteeism, as were perceived acceptable and non-acceptable reasons for sickness absence. Organization of work and physical aspects of the workplace were also found to have an influence on attitudes towards sickness absence. The general interpretation of the findings was that attitudes towards sickness absence and sickness presenteeism among nursing home employees were embedded in situational patterns of moral relationships and were

  2. Validation of sick leave measures: self-reported sick leave and sickness benefit data from a Danish national register compared to multiple workplace-registered sick leave spells in a Danish municipality. (United States)

    Stapelfeldt, Christina Malmose; Jensen, Chris; Andersen, Niels Trolle; Fleten, Nils; Nielsen, Claus Vinther


    Previous validation studies of sick leave measures have focused on self-reports. Register-based sick leave data are considered to be valid; however methodological problems may be associated with such data. A Danish national register on sickness benefit (DREAM) has been widely used in sick leave research. On the basis of sick leave records from 3,554 and 2,311 eldercare workers in 14 different workplaces, the aim of this study was to: 1) validate registered sickness benefit data from DREAM against workplace-registered sick leave spells of at least 15 days; 2) validate self-reported sick leave days during one year against workplace-registered sick leave. Agreement between workplace-registered sick leave and DREAM-registered sickness benefit was reported as sensitivities, specificities and positive predictive values. A receiver-operating characteristic curve and a Bland-Altman plot were used to study the concordance with sick leave duration of the first spell. By means of an analysis of agreement between self-reported and workplace-registered sick leave sensitivity and specificity was calculated. Ninety-five percent confidence intervals (95% CI) were used. The probability that registered DREAM data on sickness benefit agrees with workplace-registered sick leave of at least 15 days was 96.7% (95% CI: 95.6-97.6). Specificity was close to 100% (95% CI: 98.3-100). The registered DREAM data on sickness benefit overestimated the duration of sick leave spells by an average of 1.4 (SD: 3.9) weeks. Separate analysis on pregnancy-related sick leave revealed a maximum sensitivity of 20% (95% CI: 4.3-48.1).The sensitivity of self-reporting at least one or at least 56 sick leave day/s was 94.5 (95% CI: 93.4 - 95.5) % and 58.5 (95% CI: 51.1 - 65.6) % respectively. The corresponding specificities were 85.3 (95% CI: 81.4 - 88.6) % and 98.9 (95% CI: 98.3 - 99.3) %. The DREAM register offered valid measures of sick leave spells of at least 15 days among eldercare employees. Pregnancy

  3. Validation of sick leave measures: self-reported sick leave and sickness benefit data from a Danish national register compared to multiple workplace-registered sick leave spells in a Danish municipality

    Directory of Open Access Journals (Sweden)

    Stapelfeldt Christina Malmose


    Full Text Available Abstract Background Previous validation studies of sick leave measures have focused on self-reports. Register-based sick leave data are considered to be valid; however methodological problems may be associated with such data. A Danish national register on sickness benefit (DREAM has been widely used in sick leave research. On the basis of sick leave records from 3,554 and 2,311 eldercare workers in 14 different workplaces, the aim of this study was to: 1 validate registered sickness benefit data from DREAM against workplace-registered sick leave spells of at least 15 days; 2 validate self-reported sick leave days during one year against workplace-registered sick leave. Methods Agreement between workplace-registered sick leave and DREAM-registered sickness benefit was reported as sensitivities, specificities and positive predictive values. A receiver-operating characteristic curve and a Bland-Altman plot were used to study the concordance with sick leave duration of the first spell. By means of an analysis of agreement between self-reported and workplace-registered sick leave sensitivity and specificity was calculated. Ninety-five percent confidence intervals (95% CI were used. Results The probability that registered DREAM data on sickness benefit agrees with workplace-registered sick leave of at least 15 days was 96.7% (95% CI: 95.6-97.6. Specificity was close to 100% (95% CI: 98.3-100. The registered DREAM data on sickness benefit overestimated the duration of sick leave spells by an average of 1.4 (SD: 3.9 weeks. Separate analysis on pregnancy-related sick leave revealed a maximum sensitivity of 20% (95% CI: 4.3-48.1. The sensitivity of self-reporting at least one or at least 56 sick leave day/s was 94.5 (95% CI: 93.4 – 95.5 % and 58.5 (95% CI: 51.1 – 65.6 % respectively. The corresponding specificities were 85.3 (95% CI: 81.4 – 88.6 % and 98.9 (95% CI: 98.3 – 99.3 %. Conclusions The DREAM register offered valid measures of sick

  4. Posterior Fossa Decompression with Duraplasty in Chiari-1 Malformations

    International Nuclear Information System (INIS)

    Rehman, L.; Akbar, H.; Bokhari, I.; Babar, A. K.; Hahim, A. S. M.; Arain, S. H.


    Objective: To evaluate the symptomatic outcome after PFD (Posterior Fossa Decompression) with duraplasty in Chiari-1 malformations. Study Design: Case series. Place and Duration of Study: Department of Neurosurgery, JPMC, Karachi, from July 2008 to September 2012. Methodology: This included 21 patients of Chiari 1 malformations admitted in department through OPD with clinical features of headache, neck pain, numbness, neurological deficit, and syringomyelia. Diagnosis was confirmed by MRI. PFD followed by C1 laminectomy with duraplasty was done in all cases and symptomatic outcome was assessed in follow-up clinic. Results: Among 21 patients, 13 were females and 8 were males. Age ranged from 18 to 40 years. All the patients had neck pain and numbness in hands. Only 3 patients had weakness of all four limbs and 12 with weakness of hands. Symptoms evolved over a mean of 12 months. Syringomyelia was present in all cases. All patients underwent posterior fossa decompression with duraplasty with an additional C1 laminectomy and in 2 cases C2 laminectomy was done. Syringo-subarachnoid shunt was placed in one patient and ventriculo-peritoneal shunt was placed in 2 patients. Pain was relieved in all cases. Weakness was improved in all cases and numbness was improved in 19 cases. Syringomyelia was improved in all cases. Postoperative complications included CSF leak in 2 patients and wound infection in one patient. However, there was no mortality. Conclusion: Posterior fossa decompression with duraplasty is the best treatment option for Chiari-1 malformations because of symptomatic improvement and less chances of complications. (author)

  5. Piezosurgery for orbital decompression surgery in thyroid associated orbitopathy. (United States)

    Ponto, Katharina A; Zwiener, Isabella; Al-Nawas, Bilal; Kahaly, George J; Otto, Anna F; Karbach, Julia; Pfeiffer, Norbert; Pitz, Susanne


    The purpose of this study was to assess a piezosurgical device as a novel tool for bony orbital decompression surgery. At a multidisciplinary orbital center, 62 surgeries were performed in 40 patients with thyroid associated orbitopathy (TAO). Within this retrospective case-series, we analyzed the medical records of these consecutive unselected patients. The reduction of proptosis was the main outcome measure. Indications for a two (n = 27, 44%) or three wall (35, 56%) decompression surgery were proptosis (n = 50 orbits, 81%) and optic neuropathy (n = 12, 19%). Piezosurgery enabled precise bone cuts without intraoperative complications. Proptosis decreased from 23.6 ± 2.8 mm (SD) by 3 mm (95% CI: -3.6 to -2.5 mm) after surgery and stayed stable at 3 months (-3 mm, 95% CI: -3.61 to -2.5 mm, p 24 mm versus ≤ 24 mm: -3.4 mm versus -2.81 mm before discharge from hospital and -4.1 mm versus -2.1 mm at 3 months: p < 0.001, respectively). After a mean long-term follow-up period of 14.6 ± 10.4 months proptosis decreased by further -0.7 ± 2.0 mm (p < 0.001). Signs of optic nerve compression improved after surgery. Infraorbital hypesthesia was present in 11 of 21 (52%) orbits 3 months after surgery. The piezosurgical device is a useful tool for orbital decompression surgery in TAO. By cutting bone selectively, it is precise and reduces the invasiveness of surgery. Nevertheless, no improvement in outcome or reduction in morbidity over conventional techniques has been shown so far. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  6. SLAP repair with arthroscopic decompression of spinoglenoid cyst

    Directory of Open Access Journals (Sweden)

    Hashiguchi Hiroshi


    Full Text Available Introduction: A spinoglenoid cyst with suprascapular nerve disorders is highly associated with superior labrum anterior posterior (SLAP lesion. Conservative or surgical treatment is applied to relieve pain and neurological symptoms. The purpose of this study was to evaluate clinical outcomes of patients treated by arthroscopic surgery for SLAP lesion with a spinoglenoid cyst. Methods: The subjects of this study were six patients with SLAP lesion with a spinoglenoid cyst who underwent arthroscopic surgery. There was one female and five males with a mean age of 48.5 years. SLAP lesion was found in all the patients at arthroscopy. A small tear of the rotator cuff was found in the two patients. The SLAP lesion was repaired using suture anchors, and the rotator cuff tears were repaired by suture-bridge fixation. The spinoglenoid cyst was decompressed through the torn labrum in three patients, and through the released superior to posterior portion of the capsule in the other three patients. Results: All patients showed excellent improvement in pain and muscle strength at the final follow-up examination. The mean Constant score was improved from 60.5 points preoperatively to 97.2 points postoperatively. The mean visual analog scale (VAS score decreased from 4.5 on the day of the surgery to 2.5 within one week postoperatively. Postoperative MRI showed disappearance or reduction of the spinoglenoid cyst in four and two patients, respectively. There were no complications from the surgical intervention and in the postoperative period. Discussion: The patients treated by decompression through the released capsule obtained pain relief at an early period after the surgery. Arthroscopic treatment for a spinoglenoid cyst can provide a satisfactory clinical outcome. Arthroscopic decompression of a spinoglenoid cyst through the released capsule is recommended for a safe and reliable procedure for patients with suprascapular nerve disorders.

  7. Decompression illness treated in Denmark 1999-2013

    DEFF Research Database (Denmark)

    Juhl, Christian Svendsen; Hedetoft, Morten; Bidstrup, Daniel


    of previous dives, type of diving, initial type of hyperbaric treatment and DCI symptoms. Trend in annual case numbers was evaluated using run chart analysis and Spearman's correlation. Age, height, weight, and BMI were evaluated using linear regression. The presence of long-term residual symptoms......INTRODUCTION: The incidence, diver characteristics and symptomatology of decompression illness (DCI) in Denmark has not been assessed since 1982, and the presence of long-term residual symptoms among divers receiving hyperbaric oxygen therapy in Denmark has never been estimated to our knowledge...

  8. Investigation of Hematologic and Pathologic Response to Decompression. (United States)


    in tadpole and very young kangaroos . Am. J. Physiol. 120:59—74 , 1937. 12. D’ C’~~~’ B.G. and Swanson , H. Bubble free decompression of blood samples...1955. 24. Takeda , Y. Studies of the metabol i~~ 5 and distribution of fibrino— gen in healthy men with autologous I-labe led fibrinogen. J. Clin...this connective tissue protein. However , the metabolism of bone collagen is affected by hormonal control (l0; 3l) and vitamin influences (3 ;ll). It

  9. Technique of ICP monitored stepwise intracranial decompression effectively reduces postoperative complications of severe bifrontal contusion

    Directory of Open Access Journals (Sweden)

    Guan eSun


    Full Text Available Background Bifrontal contusion is a common clinical brain injury. In the early stage, it is often mild, but it progresses rapidly and frequently worsens suddenly. This condition can become life threatening and therefore requires surgery. Conventional decompression craniectomy is the commonly used treatment method. In this study, the effect of ICP monitored stepwise intracranial decompression surgery on the prognosis of patients with acute severe bifrontal contusion was investigated. Method A total of 136 patients with severe bifrontal contusion combined with deteriorated intracranial hypertension admitted from March 2001 to March 2014 in our hospital were selected and randomly divided into two groups, i.e., a conventional decompression group and an intracranial pressure (ICP monitored stepwise intracranial decompression group (68 patients each, to conduct a retrospective study. The incidence rates of acute intraoperative encephalocele, delayed hematomas, and postoperative cerebral infarctions and the Glasgow outcome scores (GOSs 6 months after the surgery were compared between the two groups.Results (1 The incidence rates of acute encephalocele and contralateral delayed epidural hematoma in the stepwise decompression surgery group were significantly lower than those in the conventional decompression group; the differences were statistically significant (P < 0.05; (2 6 months after the surgery, the incidence of vegetative state and mortality in the stepwise decompression group were significantly lower than those in the conventional decompression group (P < 0.05; the rate of favorable prognosis in the stepwise decompression group was also significantly higher than that in the conventional decompression group (P < 0.05.Conclusions The ICP monitored stepwise intracranial decompression technique reduced the perioperative complications of traumatic brain injury through the gradual release of intracranial pressure and was beneficial to the prognosis of

  10. Occupational exposures and sick leave during pregnancy

    DEFF Research Database (Denmark)

    Hansen, Mette Lausten; Thulstrup, Ane Marie; Juhl, Mette


    OBJECTIVE: This study aimed to investigate associations between work postures, lifting at work, shift work, work hours, and job strain and the risk of sick leave during pregnancy from 10-29 completed pregnancy weeks in a large cohort of Danish pregnant women. METHODS: Data from 51 874 pregnancies...... in the Danish National Birth Cohort collected between 1996-2002 were linked to the Danish Register for Evaluation of Marginalization. Exposure information was based on telephone interviews. Hazard ratios (HR) with 95% confidence intervals (95% CI) were calculated by Cox regression analysis, using time of first...... episode of sick leave as the primary outcome. RESULTS: We found statistically significant associations between all the predictors and risk of sick leave; for non-sitting work postures (HRrange 1.55-2.79), cumulative lifting HRtrend 1.29, 95% CI 1.26-1.31, shift work (HRevening 1.90, 95% CI 1...

  11. Study of prochlorperazine (Stemetil) in radiation sickness

    International Nuclear Information System (INIS)

    Dutta, A.K.


    The incidence of radiation sickness and the efficacy of prochlorperazine in alleviating it among the patients under radiotherapy have been investigated. 116 patients from those under radiotherapy were randomly chosen. 38% of this sample developed radiation sickness symptoms (nausea and vomiting). The onset of symptoms occurred in the earlier periods of radiotherapy. The younger and older group were more susceptible to side effects of radiation. Prochlorperazine was administered immediately after the onset of symptoms of radiation sickness in the dose schedule of 10 mg twice daily for adults and was continued for 5 to 10 days after the alleviation of the symptoms. This was found to be effective in all patients. (M.G.B.)

  12. Sleeping sickness surveys: game reserve adjacent villages in Malawi

    African Journals Online (AJOL)

    Sleeping sickness surveys: game reserve adjacent villages in Malawi. ... Sera from 160 game ranger volunteers and from 82 suspected cases_of Rhodesian sleeping sickness were tested by use of ELISA, ... AJOL African Journals Online.

  13. Trends in sickness absence in Denmark

    DEFF Research Database (Denmark)

    Johansen, Kristina; Bihrmann, Kristine; Mikkelsen, Sigurd


    's Authority, and the Labor Force Survey indicated a stable and largely unaltered pattern of sickness absence during the last 20 years. Findings from Statistics Denmark showed an increase in the cumulative incidence proportion from 6.6 to 7.5% among employed people between 2000 and 2007. CONCLUSION: Our data...... a linear regression analysis to analyze time trends in sickness absence based on datasets from the Danish Employers Confederation, the State Employer's Authority, the Labour Force Survey, and Statistics Denmark. RESULTS: The findings from the Confederation of Danish Employers, the State Employer...

  14. Do lower vertebrates suffer from motion sickness? (United States)

    Lychakov, Dmitri

    The poster presents literature data and results of the author’s studies with the goal to find out whether the lower animals are susceptible to motion sickness (Lychakov, 2012). In our studies, fish and amphibians were tested for 2 h and more by using a rotating device (f = 0.24 Hz, a _{centrifugal} = 0.144 g) and a parallel swing (f = 0.2 Hz, a _{horizontal} = 0.059 g). The performed studies did not revealed in 4 fish species and in toads any characteristic reactions of the motion sickness (sopite syndrome, prodromal preparatory behavior, vomiting). At the same time, in toads there appeared characteristic stress reactions (escape response, an increase of the number of urinations, inhibition of appetite), as well as some other reactions not associated with motion sickness (regular head movements, eye retractions). In trout fry the used stimulation promoted division of the individuals into the groups differing by locomotor reaction to stress, as well as the individuals with the well-expressed compensatory reaction that we called the otolithotropic reaction. Analysis of results obtained by other authors confirms our conclusions. Thus, the lower vertebrates, unlike mammals, are immune to motion sickness either under the land conditions or under conditions of weightlessness. On the basis of available experimental data and theoretical concepts of mechanisms of development the motion sickness, formulated in several hypotheses (mismatch hypothesis, Traisman‘ s hypothesis, resonance hypothesis), there presented the synthetic hypothesis of motion sickness that has the conceptual significance. According to the hypothesis, the unusual stimulation producing sensor-motor or sensor-sensor conflict or an action of vestibular and visual stimuli of frequency of about 0.2 Hz is perceived by CNS as poisoning and causes the corresponding reactions. The motion sickness actually is a byproduct of technical evolution. It is suggested that in the lower vertebrates, unlike mammals

  15. Does paternity leave affect mothers’ sickness absence


    Bratberg, Espen; Naz, Ghazala


    Female labour force participation is high in Norway but sickness absence rates are higher for women than for men. This may be partly a result of unequal sharing of childcare in the family. In this paper, we consider the effect of paternity leave on sickness absence among women who have recently given birth. We draw on a six-year panel taken from full population data from administrative sources. We find that in the 6% of families where fathers take out leave more than the standard quota (gende...

  16. Is part-time sick leave helping the unemployed?


    Andrén, Daniela


    Using a discrete choice one-factor model, we estimate mean treatment parameters and distributional treatment parameters to analyze the effects of degree of sick leave on the probability of full recovery of lost work capacity for employed and unemployed individuals, respectively. Our results indicate that one year after the sick leave spell started, the average potential impact of part-time sick listing on an individual randomly chosen from the population on sick leave was positive for both gr...

  17. Effect of active compression-decompression resuscitation (ACD-CPR) on survival: a combined analysis using individual patient data

    DEFF Research Database (Denmark)

    Mauer, Dietmar; Nolan, Jerry; Plaisance, Patrick


    Cardiopulmonary resuscitation, compression, decompression, cardiac arrest, emergency medical service, advanced cardiac life support, survival......Cardiopulmonary resuscitation, compression, decompression, cardiac arrest, emergency medical service, advanced cardiac life support, survival...

  18. Deep lateral wall orbital decompression following strabismus surgery in patients with Type II ophthalmic Graves' disease. (United States)

    Ellis, Michael P; Broxterman, Emily C; Hromas, Alan R; Whittaker, Thomas J; Sokol, Jason A


    Surgical management of ophthalmic Graves' disease traditionally involves, in order, orbital decompression, followed by strabismus surgery and eyelid surgery. Nunery et al. previously described two distinct sub-types of patients with ophthalmic Graves' disease; Type I patients exhibit no restrictive myopathy (no diplopia) as opposed to Type II patients who do exhibit restrictive myopathy (diplopia) and are far more likely to develop new-onset worsening diplopia following medial wall and floor decompression. Strabismus surgery involving extra-ocular muscle recession has, in turn, been shown to potentially worsen proptosis. Our experience with Type II patients who have already undergone medial wall and floor decompression and strabismus surgery found, when additional decompression is necessary, deep lateral wall decompression (DLWD) appears to have a low rate of post-operative primary-gaze diplopia. A case series of four Type II ophthalmic Graves' disease patients, all of whom had already undergone decompression and strabismus surgery, and went on to develop worsening proptosis or optic nerve compression necessitating further decompression thereafter. In all cases, patients were treated with DLWD. Institutional Review Board approval was granted by the University of Kansas. None of the four patients treated with this approach developed recurrent primary-gaze diplopia or required strabismus surgery following DLWD. While we still prefer to perform medial wall and floor decompression as the initial treatment for ophthalmic Graves' disease, for proptosis following consecutive strabismus surgery, DLWD appears to be effective with a low rate of recurrent primary-gaze diplopia.

  19. Influence of surgical decompression on the expression of inflammatory and tissue repair biomarkers in periapical cysts. (United States)

    Rodrigues, Janderson Teixeira; Dos Santos Antunes, Henrique; Armada, Luciana; Pires, Fábio Ramôa


    The biologic effects of surgical decompression on the epithelium and connective tissues of periapical cysts are not fully understood. The aim of this study was to evaluate the expression of tissue repair and inflammatory biomarkers in periapical cysts before and after surgical decompression. Nine specimens of periapical cysts treated with decompression before undergoing complete enucleation were immunohistochemically analyzed to investigate the expression of interleukin-1β, tumor necrosis factor-α, transforming growth factor-β1, matrix metalloproteinase-9, Ki-67, and epidermal growth factor receptor. Expression of the biomarkers was classified as positive, focal, or negative. Ki-67 immunoexpression was calculated as a cell proliferation index. The expression of the biomarkers was compared in the specimens from decompression and from the final surgical procedure. Computed tomography demonstrated that volume was reduced in all cysts after decompression. There were no differences in the immunoexpression of the proinflammatory and tissue repair biomarkers when comparing the specimens obtained before and after the decompression. Surgical decompression was efficient in reducing the volume of periapical cysts before complete enucleation. When comparing the specimens obtained from surgical decompression and from complete surgical removal, the immunohistochemical analysis did not show a decrease in proinflammatory biomarkers; neither did it show an increase in tissue repair biomarkers. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Tension pneumothorax secondary to automatic mechanical compression decompression device. (United States)

    Hutchings, A C; Darcy, K J; Cumberbatch, G L A


    The details are presented of the first published case of a tension pneumothorax induced by an automatic compression-decompression (ACD) device during cardiac arrest. An elderly patient collapsed with back pain and, on arrival of the crew, was in pulseless electrical activity (PEA) arrest. He was promptly intubated and correct placement of the endotracheal tube was confirmed by noting equal air entry bilaterally and the ACD device applied. On the way to the hospital he was noted to have absent breath sounds on the left without any change in the position of the endotracheal tube. Needle decompression of the left chest caused a hiss of air but the patient remained in PEA. Intercostal drain insertion in the emergency department released a large quantity of air from his left chest but without any change in his condition. Post-mortem examination revealed a ruptured abdominal aortic aneurysm as the cause of death. Multiple left rib fractures and a left lung laceration secondary to the use of the ACD device were also noted, although the pathologist felt that the tension pneumothorax had not contributed to the patient's death. It is recommended that a simple or tension pneumothorax should be considered when there is unilateral absence of breath sounds in addition to endobronchial intubation if an ACD device is being used.

  1. A metastable liquid melted from a crystalline solid under decompression (United States)

    Lin, Chuanlong; Smith, Jesse S.; Sinogeikin, Stanislav V.; Kono, Yoshio; Park, Changyong; Kenney-Benson, Curtis; Shen, Guoyin


    A metastable liquid may exist under supercooling, sustaining the liquid below the melting point such as supercooled water and silicon. It may also exist as a transient state in solid-solid transitions, as demonstrated in recent studies of colloidal particles and glass-forming metallic systems. One important question is whether a crystalline solid may directly melt into a sustainable metastable liquid. By thermal heating, a crystalline solid will always melt into a liquid above the melting point. Here we report that a high-pressure crystalline phase of bismuth can melt into a metastable liquid below the melting line through a decompression process. The decompression-induced metastable liquid can be maintained for hours in static conditions, and transform to crystalline phases when external perturbations, such as heating and cooling, are applied. It occurs in the pressure-temperature region similar to where the supercooled liquid Bi is observed. Akin to supercooled liquid, the pressure-induced metastable liquid may be more ubiquitous than we thought.

  2. Decompression syndrome (Caisson disease in an Indian diver

    Directory of Open Access Journals (Sweden)

    Phatak Uday


    Full Text Available Acute decompression syndrome (Caisson′s disease is an acute neurological emergency in divers. It is caused due to release of nitrogen gas bubbles that impinge the blood vessels of the spinal cord and brain and result in severe neurodeficit. There are very few case reports in Indian literature. There are multiple factors in the pathogenesis of Acute decompression syndrome (Caisson′s disease such as health problems in divers (respiratory problems or congenital heart diseases like atrial septal defect, patent ductus arteriosus etc, speed of ascent from the depth and habits like smoking that render divers susceptible for such neurological emergency. Usually, immediate diagnosis of such a condition with MRI is not possible in hospitals in the Coastal border. Even though, MRI is performed, it has very low specificity and sensitivity. Facilities like hyperbaric oxygen treatment are virtually non-existent in these hospitals. Therefore, proper education of the divers and appropriate preventive measures in professional or recreational divers is recommended.

  3. Endoscopic Decompression and Marsupialization of A Duodenal Duplication Cyst

    Directory of Open Access Journals (Sweden)

    Eliza I-Lin Sin


    Full Text Available Introduction: Duodenal duplication cysts are rare congenital foregut anomalies, accounting for 2%–12% of all gastrointestinal tract duplications. Surgical excision entails risk of injury to the pancreaticobiliary structures due to proximity or communication with the cyst. We present a case of duodenal duplication cyst in a 3 year-old boy who successfully underwent endoscopic decompression. Case report: AT is a young boy who first presented at 15 months of age with abdominal pain. There was one subsequent episode of pancreatitis. Ultrasonography showed the typical double wall sign of a duplication cyst and magnetic resonance cholangio-pancreatography showed a large 5 cm cyst postero-medial to the second part of the duodenum, communicating with the pancreaticobiliary system and causing dilatation of the proximal duodenum. He subsequently underwent successful endoscopic ultrasound guided decompression at 3 years of age under general anesthesia, and had an uneventful postoperative recovery. Conclusion: Endoscopic ultrasound guided assessment and treatment of gastrointestinal duplication cysts is increasingly reported in adults. To the best of our knowledge, only one case of endoscopic treatment of duodenal duplication cyst, in an older child, has been reported thus far in the paediatric literature. In this paper, we review the current literature and discuss the therapeutic options of this rare condition.

  4. Needle Decompression in Appalachia Do Obese Patients Need Longer Needles?

    Directory of Open Access Journals (Sweden)

    Carter, Thomas Edward


    Full Text Available Introduction: Needle decompression of a tension pneumothorax can be a lifesaving procedure. It requires an adequate needle length to reach the chest wall to rapidly remove air. With adult obesity exceeding one third of the United States population in 2010, we sought to evaluate the proper catheter length that may result in a successful needle decompression procedure. Advance Trauma Life Support (ATLS currently recommends a 51 millimeter (mm needle, while the needles stocked in our emergency department are 46 mm. Given the obesity rates of our patient population, we hypothesize these needles would not have a tolerable success rate of 90%. Methods: We retrospectively reviewed 91 patient records that had computed tomography of the chest and measured the chest wall depth at the second intercostal space bilaterally. Results: We found that 46 mm needles would only be successful in 52.7% of our patient population, yet the ATLS recommended length of 51 mm has a success rate of 64.8%. Therefore, using a 64 mm needle would be successful in 79% percent of our patient population. Conclusion: Use of longer length needles for needle thoracostomy is essential given the extent of the nation’s adult obesity population. [West J Emerg Med. 2013;14(6:650-652.

  5. Laser Disc Decompression In Emam Khomeini Hospital 1996-1999

    Directory of Open Access Journals (Sweden)

    Ghaffar Poor. M


    Full Text Available Low back pain is among the most frequent medical complaints and a major public health problem. 1.7 percent of cases are caused by herniated disc, 20 percent of which require interventional treatment. Percutaneous laser disc decompression (P.L.DD can be considered as an effective therapeutic alternative in certain cases."nMaterials and Methods: To determine the efficacy of this method in Iran in patient's with low back pain due to disc herniation, 40 patients according to medical history, physical examination and MRI findings were selected for this study. Patients who had canal stenosis, marginal, osteophyte, advanced disc dehydration, ruptured posterior ligament and other contraindication were excluded. CT scan was used only for needle navigation. After proper positioning of needle, nucleous pulposus was evapourated with Nd-YAG laser. Total energy was 1200-1600j. The procedure was done out patient and follow up has been done at 1 day, 1 week, 1,3, 6 and 12 months."nResults: There was no serious complication. 80 percent of patients in one-year follow up showed significant clinical improvement."nConclusion: Our findings suggests that percutaneous laser disc decompression can be considered as an effective alternative method of treatment for disc herniation and patient selection is the critical factor which determines success rate.

  6. Determinants of sick-leave duration : A tool for managers?

    NARCIS (Netherlands)

    Flach, P.A.; Krol, B.; Groothoff, J.W.

    AIMS: To provide managers with tools to manage episodes of sick-leave of their employees, the influence of factors such as age, gender, duration of tenure, working full-time or part-time, cause and history of sick-leave, salary and education on sick-leave duration was studied. METHOD: In a

  7. How Safe Is Measles Immunization Of Sick Children? | Ogbonna ...

    African Journals Online (AJOL)

    A prospective study to ascertain how safe is maeales immunization of sick children was carried out in Jos University Teaching Hospital, Family Health Centre. Out of 125 children who were vaccinated against measles 17(16%) were sick at the time of vaccination. Two (12%) of the sick children had post vaccination reaction.

  8. Reliability of sickness certificates in detecting potential sick leave reduction by modifying working conditions: a clinical epidemiology study

    Directory of Open Access Journals (Sweden)

    Johnsen Roar


    Full Text Available Abstract Background Medical sickness certificates are generally the main source for information when scrutinizing the need for aimed intervention strategies to avoid or reduce the individual and community side effects of sick leave. This study explored the value of medical sickness certificates related to daily work in Norwegian National Insurance Offices to identify sick-listed persons, where modified working conditions might reduce the ongoing sick leave. Methods The potential for reducing the ongoing sick leave by modifying working conditions was individually assessed on routine sickness certificates in 999 consecutive sick leave episodes by four Norwegian National Insurance collaborators, two with and two without formal medical competence. The study took place in Northern Norway in 1997 and 1998. Agreement analysed with differences against mean, kappa, and proportional-agreement analysis within and between groups of assessors was used in the judgement. Agreements between the assessors and the self-assessment of sick-listed subjects were additionally analysed in 159 sick-leave episodes. Results Both sick-listed subjects and National Insurance collaborators anticipated a potential reduction in sick leave in 20–30% of cases, and in another 20% the potential was assessed as possible. The chance corrected agreements, however, were poor (k Conclusion Information in medical sickness certificates proved ineffective in detecting cases where modified working conditions may reduce sick leave, and focusing on medical certificates may prevent identification of needed interventions. Strategies on how to communicate directly with sick-listed subjects would enable social authorities to exploit more of the sick leave reduction potential by modifying the working conditions than strategies on improving medical information.

  9. Cerebral blood flow in acute mountain sickness

    DEFF Research Database (Denmark)

    Jensen, J B; Wright, Anne; Lassen, N A


    Changes in cerebral blood flow (CBF) were measured using the radioactive xenon technique and were related to the development of acute mountain sickness (AMS). In 12 subjects, ascending from 150 to 3,475 m, CBF was 24% increased at 24 h [45.1 to 55.9 initial slope index (ISI) units] and 4% increased...

  10. [The sick individual as a concept]. (United States)

    Tejerizo López, Luis Carlos


    We start from the premise, shared by some current philosophical movements and by the author, which states that philosophy is not contemplation, or reflection, or introspection or communication. Philosophy is the art of shaping, inventing and creating concepts. It is an explicit way of introducing new differences in life, a different reading level, a specific jargon, which may imply revealing the flip side of the coin, or a dissimilar view of the side facing us. The philosopher is the friend of the concept, he holds it in his power, which means, basically and in all honesty, that philosophy is the discipline of creating concepts. Let us remember the brilliant idea of the Russian director Tarkovsky, who announced his greatest ambition as an artist: "To capture time". At the same time, we must recall one of the sayings of this director: "Every film I have directed and I intend to direct is always tied to characters who have something to overcome". The healthy individual lives in a specific time, with precise coordinates, aware that his life consists only of living that time. That is, living as defined by Josep María Esquirol: "Then we could also see that the best way of living the present is not to run after the fleeing time, but to see and live the opportunity that appears before us". One of the many circumstances that can intercept the way we see and live the opportunity that appears before us is sickness, one of those inescapable experiences we have not been taught how to pay an adequate attention to, and the meaning of which can, in a way, go unnoticed. As "time" goes by, the circumstance that we consider to be the basis on which existence is founded, sickness can appear, thus introducing a new dimension in the time of the healthy individual. For this reason we, as doctors and professionals, know that sickness "is tied to characters who have something to overcome". In view of the fact that a sickness invades a healthy individual and transforms him into a sick one

  11. Sick Leave and Factors Influencing Sick Leave in Adult Patients with Atopic Dermatitis : A Cross-Sectional Study

    NARCIS (Netherlands)

    van Os-Medendorp, Harmieke; Appelman-Noordermeer, Simone; Bruijnzeel-Koomen, Carla A.F.M.; de Bruin-Weller, MS


    BACKGROUND: Little is known about the prevalence of sick leave due to atopic dermatitis (AD). The current literature on factors influencing sick leave is mostly derived from other chronic inflammatory diseases. This study aimed to determine the prevalence of sick leave due to AD and to identify

  12. Stroboscopic Goggles for Reduction of Motion Sickness (United States)

    Reschke, M. F.; Somers, Jeffrey T.


    A device built around a pair of electronic shutters has been demonstrated to be effective as a prototype of stroboscopic goggles or eyeglasses for preventing or reducing motion sickness. The momentary opening of the shutters helps to suppress a phenomenon that is known in the art as retinal slip and is described more fully below. While a number of different environmental factors can induce motion sickness, a common factor associated with every known motion environment is sensory confusion or sensory mismatch. Motion sickness is a product of misinformation arriving at a central point in the nervous system from the senses from which one determines one s spatial orientation. When information from the eyes, ears, joints, and pressure receptors are all in agreement as to one s orientation, there is no motion sickness. When one or more sensory input(s) to the brain is not expected, or conflicts with what is anticipated, the end product is motion sickness. Normally, an observer s eye moves, compensating for the anticipated effect of motion, in such a manner that the image of an object moving relatively to an observer is held stationary on the retina. In almost every known environment that induces motion sickness, a change in the gain (in the signal-processing sense of gain ) of the vestibular system causes the motion of the eye to fail to hold images stationary on the retina, and the resulting motion of the images is termed retinal slip. The present concept of stroboscopic goggles or eyeglasses (see figure) is based on the proposition that prevention of retinal slip, and hence, the prevention of sensory mismatch, can be expected to reduce the tendency toward motion sickness. A device according to this concept helps to prevent retinal slip by providing snapshots of the visual environment through electronic shutters that are brief enough that each snapshot freezes the image on each retina. The exposure time for each snapshot is less than 5 ms. In the event that a higher

  13. Part-Time Sick Leave as a Treatment Method?


    Andrén D; Andrén T


    This paper analyzes the effects of being on part-time sick leave compared to full-time sick leave on the probability of recovering (i.e., returning to work with full recovery of lost work capacity). Using a discrete choice one-factor model, we estimate mean treatment parameters and distributional treatment parameters from a common set of structural parameters. Our results show that part-time sick leave increases the likelihood of recovering and dominates full-time sick leave for sickness spel...

  14. Effectiveness of early decompressive surgery for massive hemispheric embolic infarction

    International Nuclear Information System (INIS)

    Osada, Hideo; Mori, Kentaro; Yamamoto, Takuji; Nakao, Yasuaki; Oyama, Kazutaka; Esaki, Takanori; Watanabe, Mitsuya


    Massive hemispheric embolic infarction associated with acute brain swelling and rapid clinical deterioration is known as malignant infarction because of the significant rates of mortality and morbidity. Decompressive hemicraniectomy is effective; however, the timing and outcome still remain unclear. Ninety-four patients with massive embolic hemispheric infarctions (infarct volume >200 ml) were retrospectively divided into 3 groups: 29 patients, treated conservatively (conservative group); 33 patients, operated on after the appearance of signs of brain herniation (late surgery group); and 32 patients, operated on before the onset of signs of brain herniation signs (early surgery group). The mortality at 1 and 6 months in the late surgery group (15.2% and 24.2%, respectively) was significantly improved as compared to the conservative group (62.1% and 69.0%, respectively) (p 200 ml) should be performed before the onset of brain herniation. Early surgery may achieve a satisfactory functional recovery. (author)

  15. Feedback control of thermal instability by compression and decompression

    International Nuclear Information System (INIS)

    Okamoto, M.; Hirano, K.; Amano, T.; Ohnishi, M.


    Active feedback control of the fusion output power by means of plasma compression-decompression is considered with the purpose of achieving steady-state plasma ignition in a tokamak. A simple but realistic feedback control system is modelled and zero-dimensional energy balance equations are solved numerically by taking into account the errors in the measurements, a procedure that is necessary for the feedback control. It is shown that the control can stabilize the thermal runaway completely and maintain steady-state operation without any significant change in major radius or thermal output power. Linear stability is analysed for a general type of scaling law, and the dependence of the stability conditions on the scaling law is studied. The possibility of load-following operation is considered. Finally, a one-dimensional analysis is applied to the large-aspect-ratio case. (author)

  16. The potential role of perfluorocarbon emulsions in decompression illness. (United States)

    Spiess, Bruce D


    Decompression illness (DCI) is an occasional occurrence in sport, professional, and military diving as well as a potential catastrophe in high-altitude flight, space exploration, mining, and caisson bridge construction. DCI theoretically could be a success-limiting problem in escape from a disabled submarine (DISSUB). Perfluorocarbon emulsions (PFCs) have previously been investigated as 'blood substitutes' with one approved by the United States Food and Drug Administration for the treatment of myocardial ischaemia. PFCs possess enhanced (as compared to plasma) respiratory gas solubility characteristics, including oxygen, nitrogen and carbon dioxide. This review examines approximately 30 years of research regarding the utilization of PFCs in gas embolism as well as experimental DCI. To date, no humans have been treated with PFCs for DCI.

  17. Influenza in workplaces: transmission, workers' adherence to sick leave advice and European sick leave recommendations. (United States)

    Edwards, Christina Hansen; Tomba, Gianpaolo Scalia; de Blasio, Birgitte Freiesleben


    Knowledge about influenza transmission in the workplace and whether staying home from work when experiencing influenza-like illness can reduce the spread of influenza is crucial for the design of efficient public health initiatives. This review synthesizes current literature on sickness presenteeism and influenza transmission in the workplace and provides an overview of sick leave recommendations in Europe for influenza. A search was performed on Medline, Embase, PsychINFO, Cinahl, Web of Science, Scopus and SweMed to identify studies related to workplace contacts, -transmission, -interventions and compliance with recommendations to take sick leave. A web-based survey on national recommendations and policies for sick leave during influenza was issued to 31 European countries. Twenty-two articles (9 surveys; 13 modelling articles) were eligible for this review. Results from social mixing studies suggest that 20-25% of weekly contacts are made in the workplace, while modelling studies suggest that on average 16% (range 9-33%) of influenza transmission occurs in the workplace. The effectiveness of interventions to reduce workplace presenteeism is largely unknown. Finally, estimates from studies reporting expected compliance with sick leave recommendations ranged from 71 to 95%. Overall, 18 countries participated in the survey of which nine (50%) had issued recommendations encouraging sick employees to stay at home during the 2009 A(H1N1) pandemic, while only one country had official recommendations for seasonal influenza. During the 2009 A(H1N1) pandemic, many European countries recommended ill employees to take sick leave. Further research is warranted to quantify the effect of reduced presenteeism during influenza illness. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association.

  18. Influenza in workplaces: transmission, workers’ adherence to sick leave advice and European sick leave recommendations (United States)

    Tomba, Gianpaolo Scalia; de Blasio, Birgitte Freiesleben


    Background: Knowledge about influenza transmission in the workplace and whether staying home from work when experiencing influenza-like illness can reduce the spread of influenza is crucial for the design of efficient public health initiatives. Aim: This review synthesizes current literature on sickness presenteeism and influenza transmission in the workplace and provides an overview of sick leave recommendations in Europe for influenza. Methods: A search was performed on Medline, Embase, PsychINFO, Cinahl, Web of Science, Scopus and SweMed to identify studies related to workplace contacts, -transmission, -interventions and compliance with recommendations to take sick leave. A web-based survey on national recommendations and policies for sick leave during influenza was issued to 31 European countries. Results: Twenty-two articles (9 surveys; 13 modelling articles) were eligible for this review. Results from social mixing studies suggest that 20–25% of weekly contacts are made in the workplace, while modelling studies suggest that on average 16% (range 9–33%) of influenza transmission occurs in the workplace. The effectiveness of interventions to reduce workplace presenteeism is largely unknown. Finally, estimates from studies reporting expected compliance with sick leave recommendations ranged from 71 to 95%. Overall, 18 countries participated in the survey of which nine (50%) had issued recommendations encouraging sick employees to stay at home during the 2009 A(H1N1) pandemic, while only one country had official recommendations for seasonal influenza. Conclusions: During the 2009 A(H1N1) pandemic, many European countries recommended ill employees to take sick leave. Further research is warranted to quantify the effect of reduced presenteeism during influenza illness. PMID:27060594

  19. Unusual Clinical Presentation and Role of Decompressive Craniectomy in Herpes Simplex Encephalitis. (United States)

    Singhi, Pratibha; Saini, Arushi Gahlot; Sahu, Jitendra Kumar; Kumar, Nuthan; Vyas, Sameer; Vasishta, Rakesh Kumar; Aggarwal, Ashish


    Decompressive craniectomy in pediatric central nervous infections with refractory intracranial hypertension is less commonly practiced. We describe improved outcome of decompressive craniectomy in a 7-year-old boy with severe herpes simplex encephalitis and medically refractory intracranial hypertension, along with a brief review of the literature. Timely recognition of refractory intracranial hypertension and surgical decompression in children with herpes simplex encephalitis can be life-saving. Additionally, strokelike atypical presentations are being increasingly recognized in children with herpes simplex encephalitis and should not take one away from the underlying herpes simplex encephalitis. © The Author(s) 2014.

  20. Evaluation on therapeutic effect of de-compressive craniectomies for patients with diffuse brain swelling

    International Nuclear Information System (INIS)

    Xiao Sanchao; Zhang Changrong; Zuo Yi; Zhou Xiaowei; Li Jian


    Objective: To evaluate the therapeutic effect of de-compressive craniectomies in acute traumatic patients with diffuse brain swelling. Methods: 23 patients with acute posttraumatic diffuse brain swelling admitted and confirmed by X-CT were randomly treated by surgical de-compressive craniectomies (operative group). Their treated results were compared with those of another 11 patients treated conservatively (non-operative group) at the same period. Results: The mortality rate was similar in both operative and nonoperative groups. Conclusion: The de-compressive craniectomy operation has no value and not valid for treatment of acute posttraumatic diffuse brain swelling

  1. Diagnosis of moderate acute radiation sickness

    International Nuclear Information System (INIS)

    Yu Shoucheng; Chen Zhijian; Chen Youxin


    Forty patients with malignant lymphoma were given 60 Co TLI. 21 cases received 6 Gy and 19 received 8 Gy. It was estimated that a single TLI of 6 and 8 Gy would correspond to TBI of 3.55 Gy and 4.25 Gy (average values) by analysing peripheral blood cell chromosome aberrations and 1.85-2.37 Gy by measuring red bone marrow stem cells clinically. Moderate acute radiation sickness with digestive tract reaction and hemopoietic and immunologic depression was observed. WBC and platelets decreased rapidly. Lymphocytes showed quantitative and qualitative changes even at early stage. All these indexes are significant for diagnosis. Besides, the degree of labial stimulation response, levels of C-reactive protein, corticoid, and urinal nucleoside and alkaloid base presented great changes both pre-and post-irradiation. Early diagnosis of moderate acute radiation sickness could be made in cancer patients subjected to 6-8 Gy TLI

  2. Sickness absence and sickness attendance--what people with neck or back pain think. (United States)

    Hansson, Margareta; Boström, Carina; Harms-Ringdahl, Karin


    This study explores the decision of 33 men and women to be sick-listed from work for neck pain or low-back pain. Qualitative interviews with the subjects, who lived in a city or a sparsely populated area of Sweden, were tape-recorded, transcribed and analysed in the interpretive tradition by the three authors. New, intense and threatening pain quickly made persons report sick. For other pain, sickness absence, its timing and duration, were negotiated on the basis of the subjects' self-image, work-duty norms, organisational and extra-organisational work factors. Thirty-one people aimed to return to work, but spine-related pain was a hindrance. Five strategies to avoid, delay or shorten sickness absence were identified. Concepts of the illness flexibility model well described how the workers balanced the factors driving them from work and those forcing them or attracting them to remain. The conclusion is that reporting sick is neither undertaken lightly nor for short-term reasons only. Instead, personal history and anticipated future, spine-related pain, workplace and labour market factors are also important considerations.

  3. Prediction of sickness absenteeism, disability pension and sickness presenteeism among employees with back pain. (United States)

    Bergström, Gunnar; Hagberg, Jan; Busch, Hillevi; Jensen, Irene; Björklund, Christina


    The primary aim of this study was to evaluate the predictive ability of the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) concerning long-term sick leave, sickness presenteeism and disability pension during a follow-up period of 2 years. The study group consisted of 195 employees visiting the occupational health service (OHS) due to back pain. Using receiver operating characteristic (ROC) curves, the area under the curve (AUC) varied from 0.67 to 0.93, which was from less accurate for sickness presenteeism to highly accurate for the prediction of disability pension. For registered sick leave during 6 months following the baseline the AUC from the ROC analyses was moderately accurate (0.81) and a cut off score of 90 rendered a high sensitivity of 0.89 but a low specificity of 0.46 whereas a cut off score of 105 improves the specificity substantially but at the cost of some sensitivity. The predictive ability appears to decrease with time. Several workplace factors beyond those included in the ÖMPSQ were considered but only social support at the workplace was significantly related to future long-term sick leave besides the total score of the ÖMPSQ. The results of this study extend and confirm the findings of earlier research on the ÖMPSQ. Assessment of psychosocial risk factors among employees seeking help for back pain at the OHS could be helpful in the prevention of work disabling problems.

  4. The Negotiation of the Sick Role

    DEFF Research Database (Denmark)

    Mik-Meyer, Nanna; Roelsgaard Obling, Anne


    ’s particular circumstances in deciding whether that patient is legitimately sick. The doctor is thus a gatekeeper of legitimacy. This article presents results from a qualitative interview study conducted in Denmark with GPs concerning their approach to patients with MUS. We employ a symbolic interaction...... to which GPs are able to constitute these patients as people with social problems and problematic personality traits....

  5. Absenteeism due to sickness in coal miners

    Energy Technology Data Exchange (ETDEWEB)

    Szymczykiewicz, K.


    During two consecutive years sickness absence of 8005 miners from two pit coal mines (A and B) of different geological structure and mechanization degree was analysed. It was found that in mine ''A'' 37% had no sick leaves, whereas in mine ''B''--28%. Absence rate was similar in both mines (though the miners' work and living conditions differed), i.e. 5.21% in mine ''A'', and 5.98% in mine ''B''. Thus work and living conditions do not determine general sickness absence rate. The highest absence in both mines was that of miners frequently falling ill for a long time (approx. 5.5% miners). For the group the number of work disablement days was 28.8 and 26.7, respectively. Underground miners' sickness absence was higher than that of surface workers, the rate being 3.8 and 4.0 and 1.1 and 2.1, respectively. The highest absence was that of miners travelling to work on motor cycles (7.1 and 7.3) and bicycles (6.4 and 6.7). Those working regularly in the first shift were more frequently absent from work than those working in different shifts. Miners living in worse conditions had higher absence rate than those living in flats of a higher standard. Also elderly employees and those having children represented a higher absence rate. The highest absence rate was that of workers having four children, the lowest--that of single persons. In addition, specific absence rate of men, especially due to respiratory and circulatory system diseases, was found to be enhanced by smoking. Absence rate of smokers was 2--3 times higher than that of non-smokers.

  6. Sickness Absence: a Pan-European Study


    Livanos, Ilias; Zangelidis, Alexandros


    This study, using the EU-LFS, examines the determinants of sickness absence in 26 EU countries. The analysis highlights the importance of demographic and workplace characteristics and of institutional and societal conditions. Female workers aged 26-35 exhibit higher absenteeism, possibly reflecting the level of high household labour pressure. Increased job insecurity, captured by temporary contracts, and labour market uncertainty, reflected in higher unemployment rates, have a negative effect...

  7. Work, Sickness, Absence, and Identity-Work


    Trude Gjernes


    This article explores how a group of industrial workers experience long-term sickness absence and how they cope with this situation. The article presents data from in-depth interviews with male industrial workers employed in a Norwegian factory. The findings suggest that the factory workers handle their failing health by engaging in activities other than wage work. They did not accept a social situation characterized by passivity, social isolation, marginalization, or loss of self. The worker...

  8. A study on models of the inhomogeneity of the decompression in a bubble chamber

    International Nuclear Information System (INIS)

    Badier, J.


    Before building a hydrogen bubble chamber with liquid decompression the 'Saturne' cyclotron department wished to study for this chamber a shape leading to a homogeneous decompression as far as possible, without the production of vortices even after prolonged operation. The 'Office National d'Etudes et de Recherches Aeronautiques' (ONERA) were ready to carry out experiments on a model by strioscopy. The model was filled with air but an attempt was made to simulate the actual conditions as far as possible by varying the speed of the piston. The model was placed at one end of a tunnel, at the other end of which were produced alternatively compression and decompression waves. The study made it possible to conclude that it was necessary to make the base of the chamber round and that, in the space between the decompression cylinder and the body of the chamber it was advantageous to use 5 fins instead of 3. (author) [fr

  9. Decompressive craniectomy in aneurysmal subarachnoid haemorrhage for hematoma or oedema versus secondary infarction

    NARCIS (Netherlands)

    Goedemans, Taco; Verbaan, Dagmar; Coert, Bert A.; Sprengers, Marieke E. S.; van den Berg, René; Vandertop, W. Peter; van den Munckhof, Pepijn


    Decompressive craniectomy (DC) has been proposed as lifesaving treatment in aneurysmal subarachnoid haemorrhage (aSAH) patients with elevated intracranial pressure (ICP). However, data is sparse and controversy exists whether the underlying cause of elevated ICP influences neurological outcome. The

  10. Human Decompression Trial With 1.3 ATA Oxygen in Helium

    National Research Council Canada - National Science Library


    The Naval Medical Research Institute (NMRI) was tasked to develop helium-oxygen decompression tables for a proposed closed circuit breathing apparatus which Will deliver a constant oxygen partial pressure of 1.3 atmospheres (ATA...


    Directory of Open Access Journals (Sweden)

    V. Ya. Medvedev


    Full Text Available The article presents results of petrophysical laboratory experiments in studies of decompression phenomena associated with consequences of abrupt displacements in fault zones. Decompression was studied in cases of controlled pressure drop that caused sharp changes of porosity and permeability parameters, and impacts of such decompression were analyzed. Healing of fractured-porous medium by newly formed phases was studied. After experiments with decompression, healing of fractures and pores in silicate rock samples (3×2×2 cm, 500 °C, 100 MPa took about 800–1000 hours, and strength of such rocks was restored to 0.6–0.7 of the original value. In nature, fracture healing is influenced by a variety of factors, such as size of discontinuities in rock masses, pressure and temperature conditions, pressure drop gradients, rock composition and saturation with fluid. Impacts of such factors are reviewed.

  12. Interspinous process device versus standard conventional surgical decompression for lumbar spinal stenosis: Randomized controlled trial

    NARCIS (Netherlands)

    W.A. Moojen (Wouter); M.P. Arts (Mark); W.C.H. Jacobs (Wilco); E.W. van Zwet (Erik); M.E. van den Akker-van Marle (Elske); B.W. Koes (Bart); C.L.A.M. Vleggeert-Lankamp (Carmen); W.C. Peul (Wilco)


    markdownabstractAbstract Objective To assess whether interspinous process device implantation is more effective in the short term than conventional surgical decompression for patients with intermittent neurogenic claudication due to lumbar spinal stenosis. Design Randomized controlled

  13. Transconjunctival orbital decompression in Graves' ophthalmopathy: lateral wall approach ab interno

    NARCIS (Netherlands)

    A.D.A. Paridaens (Dion); K. Verhoeff; D. Bouwens; W.A. van den Bosch (Willem)


    textabstractAIMS: A modified surgical technique is described to perform a one, two, or three wall orbital decompression in patients with Graves' ophthalmopathy. METHODS: The lateral wall was approached ab interno through a "swinging eyelid" approach (lateral canthotomy

  14. Early versus late orbital decompression in Graves' orbitopathy: a retrospective study in 125 patients

    NARCIS (Netherlands)

    Baldeschi, Lelio; Wakelkamp, Iris M. M. J.; Lindeboom, Robert; Prummel, Marc F.; Wiersinga, Wilmar M.


    PURPOSE: To determine if early rehabilitative orbital decompression in Graves' orbitopathy (GO) leads to a more effective postoperative outcome than the same intervention performed at a later, more likely, fibrotic stage. DESIGN: Retrospective comparative case series. PARTICIPANTS: The medical

  15. GPs' negotiation strategies regarding sick leave for subjective health complaints

    DEFF Research Database (Denmark)

    Nilsen, Stein Tore; Malterud, Kirsti; Werner, Erik L.


    Objectives: To explore general practitioners ’(GPs’) specific negotiation strategies regarding sick-leave issues with patientssuffering from subjective health complaints. Design: Focus-group study. Setting: Nine focus-group interviews in three citiesin different regions of Norway. Participants: 48...... GPs (31 men, 17 women; age 32–65), participating in a course dealing with diagnostic practice and assessment of sickness certifi cates related to patients with subjective health complaints. Results: TheGPs identified some specific strategies that they claimed to apply when dealing with the question...... to sick leave. Conclusions and implications: GPs seem to have a conscious approach to negotiations of sickness certification, as they report applying specific strategies to limit the duration of sick leave due to subjective health complaints. This give-and-take way of handling sick leave negotiations has...

  16. Oxygen breathing accelerates decompression from saturation at 40 msw in 70-kg swine. (United States)

    Petersen, Kyle; Soutiere, Shawn E; Tucker, Kathryn E; Dainer, Hugh M; Mahon, Richard T


    Submarine disaster survivors can be transferred from a disabled submarine at a pressure of 40 meters of seawater (msw) to a new rescue vehicle; however, they face an inherently risky surface interval before recompression and an enormous decompression obligation due to a high likelihood of saturation. The goal was to design a safe decompression protocol using oxygen breathing and a trial-and-error methodology. We hypothesized that depth, timing, and duration of oxygen breathing during decompression from saturation play a role to mitigate decompression outcomes. Yorkshire swine (67-75 kg), compressed to 40 msw for 22 h, underwent one of three accelerated decompression profiles: (1) 13.3 h staged air decompression to 18 msw, followed by 1 h oxygen breathing, then dropout; (2) direct decompression to 18 msw followed by 1 h oxygen breathing then dropout; and (3) 1 h oxygen prebreathe at 40 msw followed by 1 h mixed gas breathing at 26 msw, 1 h oxygen breathing at 18 msw, and 1 h ascent breathing oxygen. Animals underwent 2-h observation for signs of DCS. Profile 1 (14.3 h total) resulted in no deaths, no Type II DCS, and 20% Type I DCS. Profile 2 (2.1 h total) resulted in 13% death, 50% Type II DCS, and 75% Type I DCS. Profile 3 (4.5 h total) resulted in 14% death, 21% Type II DCS, and 57% Type I DCS. No oxygen associated seizures occurred. Profile 1 performed best, shortening decompression with no death or severe DCS, yet it may still exceed emergency operational utility in an actual submarine rescue.

  17. Alternative technique in atypical spinal decompression: the use of the ultrasonic scalpel in paediatric achondroplasia (United States)

    Woodacre, Timothy; Sewell, Matthew; Clarke, Andrew J; Hutton, Mike


    Spinal stenosis can be a very disabling condition. Surgical decompression carries a risk of dural tear and neural injury, which is increased in patients with severe stenosis or an atypical anatomy. We present an unusual case of symptomatic stenosis secondary to achondroplasia presenting in a paediatric patient, and highlight a new surgical technique used to minimise the risk of dural and neural injury during decompression. PMID:27288205

  18. Bilateral Ocular Decompression Retinopathy after Ahmed Valve Implantation for Uveitic Glaucoma

    Directory of Open Access Journals (Sweden)

    Javier Flores-Preciado


    Full Text Available Case Report: We report the case of a 29-year-old man who underwent Ahmed valve implantation in both eyes as treatment for uveitic glaucoma, subsequently presenting with bilateral ocular decompression retinopathy in the postoperative period. Discussion: Ocular decompression retinopathy is a rare complication of filtering surgery in patients with glaucoma; however, the course is benign in most cases, with spontaneous resolution of bleedings and improvement of visual acuity.

  19. Left Atrial Decompression by Percutaneous Left Atrial Venting Cannula Insertion during Venoarterial Extracorporeal Membrane Oxygenation Support

    Directory of Open Access Journals (Sweden)

    Ha Eun Kim


    Full Text Available Patients with venoarterial extracorporeal membrane oxygenation (ECMO frequently suffer from pulmonary edema due to left ventricular dysfunction that accompanies left heart dilatation, which is caused by left atrial hypertension. The problem can be resolved by left atrium (LA decompression. We performed a successful percutaneous LA decompression with an atrial septostomy and placement of an LA venting cannula in a 38-month-old child treated with venoarterial ECMO for acute myocarditis.

  20. Needle Decompression of Tension Pneumothorax Tactical Combat Casualty Care Guideline Recommendations (United States)


    suspected torso trauma , consider a tension pneumothorax and decompress the chest on the side of the injury with a 14-gauge, 3.25 inch (8cm) needle...and known or suspected torso trauma , consider a tension pneumothorax and decompress the chest on the side of the injury with a 14-gauge, 3.25 inch...these studies used civilian volunteers, retrospective trauma database analysis and cadavers to measure the mean chest wall thickness. This population

  1. Some problems of antibiotic therapy in radiation sickness

    International Nuclear Information System (INIS)

    Shalnova, G.A.


    Data on the application of antibiotics and the mechanism of their action in radiation sickness are reviewed. Questions are discussed, such as the effect of antibiotics on the course and outcome of radiation sickness, the development of dysbacteriosis following irradiation, the effect of antibiotics on endogenic infection, the development of resistance of autoflora microbes to antibiotics in an irradiated organism and various aspects of the mechanism of action of antibiotics in radiation sickness. (author)

  2. A traumatic central cord syndrome occurring after adequate decompression for cervical spondylosis: biomechanics of injury: case report. (United States)

    Dickerman, Rob D; Lefkowitz, Michael; Epstein, Joseph A


    Case report with review of the literature. To present the first case of a central cord syndrome occurring after adequate decompression, and review the mechanics of the cervical spinal cord injury and postoperative biomechanical and anatomic changes occurring after cervical decompressive laminectomy. Cervical spondylosis is a common pathoanatomic occurrence in the elderly population and is thought to be one of the primary causes for a central cord syndrome. Decompressive laminectomy with or without fusion has been a primary treatment for spondylotic disease and is thought to be protective against further injury. To our knowledge, there are no cases of a central cord syndrome occurring after adequate decompression reported in the literature. Case study with extensive review of the literature. The patient underwent C3-C7 cervical laminectomy without complications. After surgery, the patient's spasticity and gait difficulties improved. She was discharged to inpatient rehabilitation for further treatment of upper extremity weakness. The patient fell in the rehabilitation center, with a central cord syndrome despite adequate decompression of her spinal canal. The patient was treated conservatively for the central cord and had minimal improvement. Decompressive laminectomy provides an immediate decompressive effect on the spinal cord as seen by the dorsal migration of the cord, however, the biomechanics of the cervical spine after decompressive laminectomy remain uncertain. This case supports the ongoing research and need for more intensive research on postoperative cervical spine biomechanics, including decompressive laminectomies, decompressive laminectomy and fusion, and laminoplasty.

  3. Evaluation of decompression tables by Doppler technique in caisson work in The Netherlands. (United States)

    Breedijk, J H; Van der Putten, G J G M; Schrier, L M; Sterk, W


    Hyperbaric work was conducted for constructing an underground tramway in the Netherlands. A total of 11,647 exposures were conducted in 41,957 hours. For these working conditions specifically developed oxygen decompression tables were used. Fifteen workers were submitted to Doppler monitoring after caisson work at a depth at 12 msw. Measurements were done according to the Canadian DCIEM protocol. For bubble grading the Kisman-Masurel 12-points ordinal scale (0-IV) was used. Bubbles were detected in 17 of the 38 examinations. The highest grade (III-) was found in four measurements. At rest the grading was never higher than I+. Two hours after decompression the grading was remarkably higher than after one hour. Bubble scores were relatively low, although the maximum grading probably is not reached within two hours after decompression. It may be concluded that the oxygen decompression tables used, were reliable under these heavy working conditions. At group level, decompression stress can be evaluated by Doppler monitoring. In order to reduce health hazard of employees, use of oxygen during decompression in caisson work should be embodied in the occupational standard.

  4. Decompression of keratocystic odontogenic tumors leading to increased fibrosis, but without any change in epithelial proliferation. (United States)

    Awni, Sarah; Conn, Brendan


    The aim of this study was to investigate whether decompression treatment induces changes in the histology or biologic behavior of keratocystic odontogenic tumor (KCOT). Seventeen patients with KCOT underwent decompression treatment with or without enucleation. Histologic evaluation and immunohistochemical expression of p53, Ki-67, and Bcl-2 were analyzed by using conventional microscopy. KCOT showed significantly increased fibrosis (P = .01) and a subjective reduction in mitotic activity (P = .03) after decompression. There were no statistically significant changes in the expression of proliferation markers. An increase in daughter-cysts or epithelial rests was seen after decompression (P = .04). Recurrence was noted in four of 16 cases, and expression of p53 was strongly correlated with prolonged duration of treatment (P = .01) and intense inflammatory changes (P = .02). Structural changes in the KCOT epithelium or capsule following decompression facilitate surgical removal of the tumor. There was no statistical evidence that decompression influences expression of proliferation markers in the lining, indicating that the potential for recurrence may not be restricted to the cellular level. The statistically significant increase of p53 expression with increased duration of treatment and increase of inflammation may also indicate the possibility of higher rates of recurrence with prolonged treatment and significant inflammatory changes. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  5. Cost-Effectiveness of Postoperative Ketamine in Chiari Decompression. (United States)

    McDowell, Michael M; Alhourani, Ahmad; Pearce-Smith, Beverly A; Mazurkiewicz, Anna; Friedlander, Robert M


    In Chiari I patients, postoperative pain and discomfort frequently slow the transition back to the home setting. We sought to determine the effect of standardized ketamine infusion protocols on hospital length of stay (LOS). This retrospective cohort study reviewed 100 consecutive adult patients undergoing Chiari I decompression. Fifty-nine patients were placed on a 2-3 mg/hr ketamine drip until postoperative day 1. This group was compared with a group who received 2-3 mg/hr of ketamine until postoperative day 2 (19 patients) and patients who did not receive ketamine at all (22 patients). Clinical characteristics, opioid use, LOS, and relative hospitalization costs were assessed. All narcotic amounts were converted into milligram equivalents of morphine. LOS of the short-ketamine group was 46.5 hours when compared with the long-ketamine group (66.8 hours) and no-ketamine group (56.9 hours). There was a statistically significant difference when comparing the short-ketamine group with the long-ketamine group and no-ketamine group together (P ketamine protocol was used (P ketamine group, 196 mg in the long-ketamine group, and 187 mg in the no-ketamine group (P = 0.65). No adverse events from ketamine were noted. Ketamine at subanesthetic levels may be an effective tool to facilitate early return home postoperatively and may significantly reduce medical costs. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Development of a finite element model of decompressive craniectomy.

    Directory of Open Access Journals (Sweden)

    Tim L Fletcher

    Full Text Available Decompressive craniectomy (DC, an operation whereby part of the skull is removed, is used in the management of patients with brain swelling. While the aim of DC is to reduce intracranial pressure, there is the risk that brain deformation and mechanical strain associated with the operation could damage the brain tissue. The nature and extent of the resulting strain regime is poorly understood at present. Finite element (FE models of DC can provide insight into this applied strain and hence assist in deciding on the best surgical procedures. However there is uncertainty about how well these models match experimental data, which are difficult to obtain clinically. Hence there is a need to validate any modelling approach outside the clinical setting. This paper develops an axisymmetric FE model of an idealised DC to assess the key features of such an FE model which are needed for an accurate simulation of DC. The FE models are compared with an experimental model using gelatin hydrogel, which has similar poro-viscoelastic material property characteristics to brain tissue. Strain on a central plane of the FE model and the front face of the experimental model, deformation and load relaxation curves are compared between experiment and FE. Results show good agreement between the FE and experimental models, providing confidence in applying the proposed FE modelling approach to DC. Such a model should use material properties appropriate for brain tissue and include a more realistic whole head geometry.

  7. Endoscopic optic nerve decompression for nontraumatic compressive optic neuropathy

    Directory of Open Access Journals (Sweden)

    Cheng-long REN


    Full Text Available Objective To describe the preliminary experience with endoscopic optic nerve decompression (EOND for nontraumatic compressive optic neuropathies (NCONs. Methods The clinical data of 10 patients, male 5 and female 5, with a mean age of 44.3±5.1 years, who underwent EOND for visual loss (n=5 or visual deterioration (n=5 due to tumor compression in General Hospital of Armed Police Forces of China in the period from April 2013 to April 2014 were analyzed retrospectively. Preoperative and 6-month-postoperative clinical and imaging data of these patients were reviewed and analyzed. Results Among 5 patients who lost light perception (including 2 patients with bilateral optic nerve compression before operation, 4 of them showed visual improvement to different degrees on the 7th day after operation (with improvement of bilateral visual acuity. The other 5 patients with visual impairment before operation recovered their visual acuity to different extent after the operation. All of the patients had no obvious post-operative complications. Conclusion EOND is a safe, effective, and minimally invasive surgical technique affording recovery of visual function to NCON patients. DOI: 10.11855/j.issn.0577-7402.2015.11.12

  8. Hydrocephalus after decompressive craniectomy for malignant hemispheric cerebral infarction. (United States)

    Wang, Qiang-Ping; Ma, Jun-Peng; Zhou, Zhang-Ming; Yang, Min; You, Chao


    Several studies have investigated the incidence and risk factors of hydrocephalus after decompressive craniectomy (DC) for malignant hemispheric cerebral infarction. However, the results are controversial. Therefore, the following is a retrospective cohort study to determine the incidence and risk factors of hydrocephalus after DC for malignant hemispheric cerebral infarction. From January 2004 to June 2014, patients at two medical centres in south-west China, who underwent DC for malignant hemispheric cerebral infarction, were included. The patients' clinical and radiologic findings were retrospectively reviewed. A chi-square test, Mann-Whitney U-test and logistic regression model were used to identify the risk factors. A total of 128 patients were included in the study. The incidence of ventriculomegaly and shunt-dependent hydrocephalus were 42.2% (54/128) and 14.8% (19/128), respectively. Lower preoperative Glasgow Coma Scale (GCS) score and presence of subarachnoid haemorrhage (SAH) were factors significantly associated with the development of post-operative hydrocephalus after DC. Cerebral infarction patients receiving DC have a moderate tendency to suffer from post-operative hydrocephalus. A poor GCS score and the presence of SAH were significantly associated with the development of hydrocephalus after DC.

  9. Gas and particle motions in a rapidly decompressed flow (United States)

    Johnson, Blair; Zunino, Heather; Adrian, Ronald; Clarke, Amanda


    To understand the behavior of a rapidly decompressed particle bed in response to a shock, an experimental study is performed in a cylindrical (D = 4.1 cm) glass vertical shock tube of a densely packed (ρ = 61%) particle bed. The bed is comprised of spherical glass particles, ranging from D50 = 44-297 μm between experiments. High-speed pressure sensors are incorporated to capture shock speeds and strengths. High-speed video and particle image velocimetry (PIV) measurements are collected to examine vertical and radial velocities of both the particles and gas to elucidate features of the shock wave and resultant expansion wave in the lateral center of the tube, away from boundaries. In addition to optically analyzing the front velocity of the rising particle bed, interaction between the particle and gas phases are investigated as the flow accelerates and the particle front becomes more dilute. Particle and gas interactions are also considered in exploring mechanisms through which turbulence develops in the flow. This work is supported by the U.S. Department of Energy, National Nuclear Security Administration, Advanced Simulation and Computing Program, as a Cooperative Agreement under the Predictive Science and Academic Alliance Program, under Contract No. DE-NA0002378.

  10. Herniation despite Decompressive Hemicraniectomy in Large Hemispherical Ischemic Strokes. (United States)

    Hinduja, Archana; Samant, Rohan; Feng, Dongxia; Hannawi, Yousef


    Despite decompressive hemicraniectomy (DHC), progressive herniation resulting in death has been reported following middle cerebral artery (MCA) strokes. We aimed to determine the surgical parameters measured on brain computed tomography (CT) scan that are associated with progressive herniation despite DHC in large MCA strokes. Retrospective chart review of medical records of patients with malignant hemispheric infarction who underwent DHC for cerebral edema was performed. Infarct volume was calculated on CT scans obtained within 24 hours of ictus. Radiological parameters of craniectomy bone flap size, brain volume protruding out of the skull, adequate centering of the craniectomy over the stroke bed, and the infarct volume outside the craniectomy bed (volume not centered [VNC]) were measured on the postoperative brain CT. Of 41 patients who underwent DHC, 7 had progressive herniation leading to death. Radiographic parameters significantly associated with progressive herniation included insufficient centering of craniectomy bed on the stroke bed (P = .03), VNC (P = .011), additional anterior cerebral artery infarction (P = .047), and smaller craniectomy length (P = .05). Multivariate logistic regression analysis for progressive herniation using craniectomy length and VNC as independent variables demonstrated that a higher VNC was significantly associated with progressive herniation despite surgery (P = .029). In large MCA strokes, identification of large infarct volume outside the craniectomy bed was associated with progressive herniation despite surgery. These results will need to be verified in larger prospective studies. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  11. Sick Leave and Factors Influencing Sick Leave in Adult Patients with Atopic Dermatitis: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Harmieke van Os-Medendorp


    Full Text Available Background: Little is known about the prevalence of sick leave due to atopic dermatitis (AD. The current literature on factors influencing sick leave is mostly derived from other chronic inflammatory diseases. This study aimed to determine the prevalence of sick leave due to AD and to identify influencing factors. Methods: A cross-sectional study was carried out in adult patients with AD. Outcome measures: sick leave during the two-week and one-year periods, socio-demographic characteristics, disease severity, quality of life and socio-occupational factors. Logistic regression analyses were used to determine influencing factors on sick leave over the two-week period. Results: In total, 253 patients were included; 12% of the patients had to take sick leave in the last two weeks due to AD and 42% in the past year. A higher level of symptom interference (OR 1.26; 95% CI 1.13–1.40 or perfectionism/diligence (OR 0.90; 95% CI 0.83–0.96 may respectively increase or decrease the number of sick leave days. Conclusion: Sick leave in patients with AD is a common problem and symptom interference and perfectionism/diligence appeared to influence it. Novel approaches are needed to deal with symptoms at work or school to reduce the amount of sick leave due to AD.

  12. Sick Leave and Factors Influencing Sick Leave in Adult Patients with Atopic Dermatitis: A Cross-Sectional Study. (United States)

    van Os-Medendorp, Harmieke; Appelman-Noordermeer, Simone; Bruijnzeel-Koomen, Carla; de Bruin-Weller, Marjolein


    Little is known about the prevalence of sick leave due to atopic dermatitis (AD). The current literature on factors influencing sick leave is mostly derived from other chronic inflammatory diseases. This study aimed to determine the prevalence of sick leave due to AD and to identify influencing factors. A cross-sectional study was carried out in adult patients with AD. sick leave during the two-week and one-year periods, socio-demographic characteristics, disease severity, quality of life and socio-occupational factors. Logistic regression analyses were used to determine influencing factors on sick leave over the two-week period. In total, 253 patients were included; 12% of the patients had to take sick leave in the last two weeks due to AD and 42% in the past year. A higher level of symptom interference (OR 1.26; 95% CI 1.13-1.40) or perfectionism/diligence (OR 0.90; 95% CI 0.83-0.96) may respectively increase or decrease the number of sick leave days. Sick leave in patients with AD is a common problem and symptom interference and perfectionism/diligence appeared to influence it. Novel approaches are needed to deal with symptoms at work or school to reduce the amount of sick leave due to AD.

  13. Positive and negative consequences of sick leave for the individual, with special focus on part-time sick leave. (United States)

    Sieurin, Leif; Josephson, Malin; Vingård, Eva


    To describe the consequences of long-term sick leave (>28 days) on working situation, health and lifestyle among employees from the public sector in Sweden. Employees in four county councils and two municipalities on long term sick leave on 1 November 2005 (n = 1,128) answered a questionnaire in February 2006. The response rate was 71.7%. Eighty seven per cent were still on sick leave when the questionnaire was answered: 54% part time and 33% full time. Reporting positive consequences was rare but reporting negative consequences, such as effects on the development of salary, the possibilities of pursuing a career or to change to another job were common. Sick leave seemed to lead to a considerable loss of zest for work, even if the respondents were back in work full time. Regardless of the negative consequences at work, 92% of those on part-time sick leave believed that the part-time sick leave was good for them even if many thought it had negative consequences for employer and colleagues. Long-term sick leave has negative consequences for the individual in work situations, even for those back at work full time. The development of salary and career seem to be most affected. The attitude towards part-time sick leave was positive and this result indicates that there is a potential for an increased degree of partial return to work in the group of people on long-term sick leave.

  14. Paid Sick Leave as a Means to Reduce Sickness Presenteeism Among Physicians

    Directory of Open Access Journals (Sweden)

    Ingrid Steen Rostad


    Full Text Available Recurrent international data show that physicians often attend work while ill, termed sickness presenteeism. The current study investigated if sickness presenteeism scores among European physicians varied according to national paid sick leave legislation. We hypothesized that prevalence of presenteeism was higher in countries with lower levels of paid sick leave. We used repeated cross-sectional survey data, phase I (2004/2005, N = 1326 and phase II (2012/2013, N = 1403, among senior consultants at university hospitals in Sweden, Norway, and Italy. Analyses of variances assessed cross-country differences in presenteeism. To assess the impact of country on presenteeism, we used multiple regression analyses controlled for sex, age, family status, work hours, and work content. The results from phase I supported the initial hypothesis. At phase II, presenteeism scores had decreased among the Italian and Swedish sample. The results are discussed with regard to changes in legislation on workhours and medical liability in Italy and Sweden between phase I and II.

  15. Changes in alcohol drinking and subsequent sickness absence. (United States)

    Salonsalmi, Aino; Rahkonen, Ossi; Lahelma, Eero; Laaksonen, Mikko


    The aim was to examine whether changes in alcohol drinking are associated with sickness absence. Repeated postal questionnaires on alcohol drinking were conducted among employees of the City of Helsinki in 2000-2 and 2007 to assess changes in drinking habits between these two time points. Data on the number of self-certified and medically confirmed sickness absences were derived from the employer's register. Sickness absences were followed from 2007 until the end of 2010 among employees participating in both questionnaire surveys. The study includes 3252 female and 682 male employees 40-60 years old at baseline. Poisson regression was used in the data analysis and population attributable fractions (PAFs) were calculated. Alcohol drinking was associated especially with self-certified sickness absence. Rate ratios (RRs) and 95% confidence intervals (CIs) for increasing weekly average drinking were 1.38, 1.18-1.62 among women and 1.58, 1.18-2.12 among men. Also stable problem drinking (for women 1.39, 1.26-1.54, for men 1.44, 1.10-1.87) and among women stable heavy drinking (1.53, 1.20-1.94) increased self-certified sickness absence. There were associations between alcohol drinking and medically confirmed sickness absence but these were mainly explained by health and health behaviours. Also, a decrease in weekly average drinking was associated with sickness absence among women whereas among men former problem drinking increased sickness absence. According to the PAF values, problem drinking had a stronger contribution to sickness absence than weekly average drinking. Alcohol drinking is particularly associated with self-certified sickness absence. Reducing adverse drinking habits is likely to prevent sickness absence. © 2015 the Nordic Societies of Public Health.

  16. Sick-visit immunizations and delayed well-baby visits. (United States)

    Robison, Steve G


    Giving recommended immunizations during sick visits for minor and acute illness such as acute otitis media has long been an American Academy of Pediatrics/Advisory Committee on Immunization Practice recommendation. An addition to the American Academy of Pediatrics policy in 2010 advised considering whether giving immunizations at the sick visit would discourage making up missed well-baby visits. This study quantifies the potential tradeoff between sick-visit immunizations and well-baby visits. This study was a retrospective cohort analysis with a case-control component of sick visits for acute otitis media that supplanted normal well-baby visits at age 2, 4, or 6 months. Infants were stratified for sick-visit immunization, no sick-visit immunization but quick makeup well-baby visits, or no sick-visit immunizations or quick makeup visits. Immunization rates and well-baby visit rates were assessed through 24 months of age. For 1060 study cases, no significant difference was detected in immunization rates or well-baby visits through 24 months of age between those with or without sick-visit immunizations. Thirty-nine percent of infants without a sick-visit shot failed to return for a quick makeup well-baby visit; this delayed group was significantly less likely to be up-to-date for immunizations (relative risk: 0.66) and had fewer well-baby visits (mean: 3.8) from 2 through 24 months of age compared with those with sick-visit shots (mean: 4.7). The substantial risk that infants will not return for a timely makeup well-baby visit after a sick visit should be included in any consideration of whether to delay immunizations.

  17. Decompression Device Using a Stainless Steel Tube and Wire for Treatment of Odontogenic Cystic Lesions: A Technical Report. (United States)

    Jung, Eun-Joo; Baek, Jin-A; Leem, Dae-Ho


    Decompression is considered an effective treatment for odontogenic cystic lesions in the jaw. A variety of decompression devices are successfully used for the treatment of keratocystic odontogenic tumors, radicular cysts, dentigerous cysts, and ameloblastoma. The purpose of these devices is to keep an opening between the cystic lesion and the oral environment during treatment. The aim of this report is to describe an effective decompression tube using a stainless steel tube and wire for treatment of jaw cystic lesions.

  18. Modified “in-window” technique for decompressive craniotomy for severe brain injury

    Directory of Open Access Journals (Sweden)

    Jovanović Momir J.


    Full Text Available Increased intracranial pressure and decreased cerebral perfusion in patients with severe traumatic brain injury are associated with cerebral ischemia and poor outcome. Lowering intracranial pressure is one of the goals of treatment. We analyzed the effects of decompressive craniotomy on intracranial pressure levels and outcome. In addition, we compared the results of decompressive craniotomy performed with our original technique (modified “in-window” technique, with no need for cranioplasty with results of classic techniques. We formed two groups: 52 patients with TBI (GCS≤8, with monitored intracranial pressure, and the control: 45 patients without intracranial pressure monitoring. In the first group, malignant intracranial hypertension was treated by decompressive craniotomy, using a modified "in-window" technique. Results were analyzed using standard statistical methods. In the first group, with intracranial pressure monitoring, 17/52 had decompressive craniotomy, and significant reduction of intracranial pressure appeared in the early postoperative period (38.82 to 22.76 mmHg, mean, with significant decrease of intracranial pressure at the end of treatment, compared to the control group (mean=25.00, and 45.30 mmHg, respectively. Late complications were similar to results of other studies. Our results were 20% of epileptic seizures, 8% of hydrocephalus, 12% contusion/hematoma progression and 12% subdural hygroma. Outcome (measured with Glasgow Outcome Score-GOS in the first group, at the time of discharge, was better with decompressive craniotomy than without decompressive craniotomy (GOS=2.47, and GOS=1.00, respectively. Modified "in-window" technique for decompressive craniotomy in severe traumatic brain injury is safe, promising and according to our experience offers a lower rate of complications with no need for additional cranioplastic surgery.

  19. Sagittal imbalance in patients with lumbar spinal stenosis and outcomes after simple decompression surgery. (United States)

    Shin, E Kyung; Kim, Chi Heon; Chung, Chun Kee; Choi, Yunhee; Yim, Dahae; Jung, Whei; Park, Sung Bae; Moon, Jung Hyeon; Heo, Won; Kim, Sung-Mi


    Lumbar spinal stenosis (LSS) is the most common lumbar degenerative disease, and sagittal imbalance is uncommon. Forward-bending posture, which is primarily caused by buckling of the ligamentum flavum, may be improved via simple decompression surgery. The objectives of this study were to identify the risk factors for sagittal imbalance and to describe the outcomes of simple decompression surgery. This is a retrospective nested case-control study PATIENT SAMPLE: This was a retrospective study that included 83 consecutive patients (M:F=46:37; mean age, 68.5±7.7 years) who underwent decompression surgery and a minimum of 12 months of follow-up. The primary end point was normalization of sagittal imbalance after decompression surgery. Sagittal imbalance was defined as a C7 sagittal vertical axis (SVA) ≥40 mm on a 36-inch-long lateral whole spine radiograph. Logistic regression analysis was used to identify the risk factors for sagittal imbalance. Bilateral decompression was performed via a unilateral approach with a tubular retractor. The SVA was measured on serial radiographs performed 1, 3, 6, and 12 months postoperatively. The prognostic factors for sagittal balance recovery were determined based on various clinical and radiological parameters. Sagittal imbalance was observed in 54% (45/83) of patients, and its risk factors were old age and a large mismatch between pelvic incidence and lumbar lordosis. The 1-year normalization rate was 73% after decompression surgery, and the median time to normalization was 1 to 3 months. Patients who did not experience SVA normalization exhibited low thoracic kyphosis (hazard ratio [HR], 1.04; 95% confidence interval [CI], 1.02-1.10) (pimbalance was observed in more than 50% of LSS patients, but this imbalance was correctable via simple decompression surgery in 70% of patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. MRI Evaluation of Post Core Decompression Changes in Avascular Necrosis of Hip. (United States)

    Nori, Madhavi; Marupaka, Sravan Kumar; Alluri, Swathi; Md, Naseeruddin; Irfan, Kazi Amir; Jampala, Venkateshwarlu; Apsingi, Sunil; Eachempati, Krishna Kiran


    Avascular necrosis of hip typically presents in young patients. Core decompression in precollapse stage provides pain relief and preservation of femoral head. The results of core decompression vary considerably despite early diagnosis. The role of MRI in monitoring patients post surgically has not been clearly defined. To study pre and post core decompression MRI changes in avascular necrosis of hip. This is a contiguous observational cohort of 40 hips treated by core decompression for precollapse avascular necrosis of femoral head, who had a baseline MRI performed before surgery. Core decompression of the femoral head was performed within 4 weeks. Follow up radiograph and MRI scans were done at six months. Harris hip score preoperatively, 1 month and 6 months after the surgery was noted. Success in this study was defined as postoperative increase in Harris hip score (HHS) by 20 points and no additional femoral collapse. End point of clinical adverse outcome as defined by fall in Harris hip score was conversion or intention to convert to total hip replacement (THR). MRI parameters in the follow up scan were compared to the preoperative MRI. Effect of core decompression on bone marrow oedema and femoral head collapse was noted. Results were analysed using SPSS software version. Harris hip score improved from 57 to 80 in all patients initially. Six hips had a fall in Harris hip score to mean value of 34.1 during follow up (9 to 12 months) and underwent total hip replacement. MRI predictors of positive outcome are lesions with grade A extent, Grade A & B location. Bone marrow oedema with lesions less than 50% involvement, medial and central location. Careful selection of patients by MR criteria for core decompression provides satisfactory outcome in precollapse stage of avascular necrosis of hip.

  1. Systematic review of active workplace interventions to reduce sickness absence. (United States)

    Odeen, M; Magnussen, L H; Maeland, S; Larun, L; Eriksen, H R; Tveito, T H


    The workplace is used as a setting for interventions to prevent and reduce sickness absence, regardless of the specific medical conditions and diagnoses. To give an overview of the general effectiveness of active workplace interventions aimed at preventing and reducing sickness absence. We systematically searched PubMed, Embase, Psych-info, and ISI web of knowledge on 27 December 2011. Inclusion criteria were (i) participants over 18 years old with an active role in the intervention, (ii) intervention done partly or fully at the workplace or at the initiative of the workplace and (iii) sickness absence reported. Two reviewers independently screened articles, extracted data and assessed risk of bias. A narrative synthesis was used. We identified 2036 articles of which, 93 were assessed in full text. Seventeen articles were included (2 with low and 15 with medium risk of bias), with a total of 24 comparisons. Five interventions from four articles significantly reduced sickness absence. We found moderate evidence that graded activity reduced sickness absence and limited evidence that the Sheerbrooke model (a comprehensive multidisciplinary intervention) and cognitive behavioural therapy (CBT) reduced sickness absence. There was moderate evidence that workplace education and physical exercise did not reduce sickness absence. For other interventions, the evidence was insufficient to draw conclusions. The review found limited evidence that active workplace interventions were not generally effective in reducing sickness absence, but there was moderate evidence of effect for graded activity and limited evidence for the effectiveness of the Sheerbrooke model and CBT.

  2. Sick leave analysis among self-employed Dutch farmers

    NARCIS (Netherlands)

    Hartman, E.; Oude Vrielink, H.H.E.; Huirne, R.B.M.; Metz, J.H.M.


    Background Agriculture is one of the most physically demanding and risky industries. Aim The objective of this study was to provide baseline data on the diagnoses, occurrence and duration of sick leave of self-employed Dutch farmers. Method A database of 22807 sick leave claims of 12627 farmers

  3. Reliability of provocative tests of motion sickness susceptibility (United States)

    Calkins, D. S.; Reschke, M. F.; Kennedy, R. S.; Dunlop, W. P.


    Test-retest reliability values were derived from motion sickness susceptibility scores obtained from two successive exposures to each of three tests: (1) Coriolis sickness sensitivity test; (2) staircase velocity movement test; and (3) parabolic flight static chair test. The reliability of the three tests ranged from 0.70 to 0.88. Normalizing values from predictors with skewed distributions improved the reliability.

  4. Return to work following sickness absence due to infectious mononucleosis

    NARCIS (Netherlands)

    Koopmans, P.C.; Bakhtali, R.; Katan, A.A.; Groothoff, J.W.; Roelen, C.A.

    BACKGROUND: Epstein-Barr virus infectious mononucleosis among adults is notorious because of the prolonged incapacitating fatigue it causes. AIMS: To investigate the duration of sickness absence and return to work following infectious mononucleosis. METHODS: Episodes of sickness absence due to

  5. Identifying employees at risk for job loss during sick leave

    NARCIS (Netherlands)

    Flach, Peter A.; Groothoff, Johan W.; Bultmann, Ute


    Purpose: To examine the associations between medical, work-related, organizational and sociodemographic factors and job loss during sick leave in a Dutch population of 4132 employees on sick leave. Methods: Data were assessed by occupational health physicians (OHPs) on sociodemographic, medical,

  6. Job satisfaction and sickness absence: a questionnaire survey. (United States)

    Roelen, Corné A M; Koopmans, Petra C; Notenbomer, Annette; Groothoff, Johan W


    When dissatisfaction with work precedes sickness absence, screening for satisfaction levels might usefully detect workers at risk of sickness absence. To investigate whether job satisfaction was associated with subsequent sickness absence days or episodes. A sample of workers was randomly drawn from a population of employees who had an episode of absence between January and April 2003. Job satisfaction was measured using a validated single question with a Likert-type scale ranging from 1 (very dissatisfied) to 7 (very satisfied). Job satisfaction levels were linked to the number of recorded sickness absence days and episodes in 2003, distinguishing between short (1-7 days) episodes and long (>7 days) episodes. Of 898 questionnaires distributed, 518 (58%) were returned. The mean+/-standard deviation job satisfaction level was 5.1+/-1.4 and negatively related to the number of sickness absence days. Job satisfaction was also negatively related to the number of short episodes and long episodes of absence, but these associations were not significant. Job satisfaction was significantly related to total sickness absence duration. The association with the number of sickness absence episodes was weak and just below the level of statistical significance. Assessing work satisfaction levels might usefully identify those workers most likely to have the greatest sickness absence duration.


    Directory of Open Access Journals (Sweden)

    E. K. Kazakova


    Full Text Available The article presents a clinical case of 2 patients with heart arrhythmias of the sick sinus syndrome type, who were implanted electriccardiac pacemakers in the acute period of cerebrovascular accidents. There were no cardiac complaints in the clinical manifestation, however, a comprehensive assessment confirmed the diagnosis of sick sinus syndrome.

  8. Does muscle strength predict future musculoskeletal disorders and sickness absence?

    DEFF Research Database (Denmark)

    Faber, A; Sell, L; Hansen, J V


    High muscle strength is considered relevant for preventing musculoskeletal disorders and long-term sickness absence. However, prospective studies on the association between muscle strength and future musculoskeletal disorders and long-term sickness absence are few and show contrasting results....

  9. Motion sickness and postural sway in console video games. (United States)

    Stoffregen, Thomas A; Faugloire, Elise; Yoshida, Ken; Flanagan, Moira B; Merhi, Omar


    We tested the hypotheses that (a) participants might develop motion sickness while playing "off-the-shelf" console video games and (b) postural motion would differ between sick and well participants, prior to the onset of motion sickness. There have been many anecdotal reports of motion sickness among people who play console video games (e.g., Xbox, PlayStation). Participants (40 undergraduate students) played a game continuously for up to 50 min while standing or sitting. We varied the distance to the display screen (and, consequently, the visual angle of the display). Across conditions, the incidence of motion sickness ranged from 42% to 56%; incidence did not differ across conditions. During game play, head and torso motion differed between sick and well participants prior to the onset of subjective symptoms of motion sickness. The results indicate that console video games carry a significant risk of motion sickness. Potential applications of this research include changes in the design of console video games and recommendations for how such systems should be used.

  10. Focus Group Study Exploring Factors Related to Frequent Sickness Absence. (United States)

    Notenbomer, Annette; Roelen, Corné A M; van Rhenen, Willem; Groothoff, Johan W


    Research investigating frequent sickness absence (3 or more episodes per year) is scarce and qualitative research from the perspective of frequent absentees themselves is lacking. The aim of the current study is to explore awareness, determinants of and solutions to frequent sickness absence from the perspective of frequent absentees themselves. We performed a qualitative study of 3 focus group discussions involving a total of 15 frequent absentees. Focus group discussions were audiotaped and transcribed verbatim. Results were analyzed with the Graneheim method using the Job Demands Resources (JD-R) model as theoretical framework. Many participants were not aware of their frequent sickness absence and the risk of future long-term sickness absence. As determinants, participants mentioned job demands, job resources, home demands, poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Managing these factors and improving communication (skills) were regarded as solutions to reduce frequent sickness absence. The JD-R model provided a framework for determinants of and solutions to frequent sickness absence. Additional determinants were poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Frequent sickness absence should be regarded as a signal that something is wrong. Managers, supervisors, and occupational health care providers should advise and support frequent absentees to accommodate job demands, increase both job and personal resources, and improve health rather than express disapproval of frequent sickness absence and apply pressure regarding work attendance.

  11. Artificial horizon effects on motion sickness and performance. (United States)

    Tal, Dror; Gonen, Adi; Wiener, Guy; Bar, Ronen; Gil, Amnon; Nachum, Zohar; Shupak, Avi


    To investigate whether the projection of Earth-referenced scenes during provocative motion can alleviate motion sickness severity and prevent motion sickness-induced degradation of performance. Exposure to unfamiliar motion patterns commonly results in motion sickness and decreased performance. Thirty subjects with moderate-to-severe motion sickness susceptibility were exposed to the recorded motion profile of a missile boat under moderate sea conditions in a 3-degrees-of-freedom ship motion simulator. During a 120-minute simulated voyage, the study participants were repeatedly put through a performance test battery and completed a motion sickness susceptibility questionnaire, while self-referenced and Earth-referenced visual scenes were projected inside the closed simulator cabin. A significant decrease was found in the maximal motion sickness severity score, from 9.83 ± 9.77 (mean ± standard deviation) to 7.23 ± 7.14 (p pitch, and heave movements of the simulator. Although there was a significant decrease in sickness severity, substantial symptoms still persisted. Decision making, vision, concentration, memory, simple reasoning, and psychomotor skills all deteriorated under the motion conditions. However, no significant differences between the projection conditions could be found in the scores of any of the performance tests. Visual information regarding the vessel's movement provided by an artificial horizon device might decrease motion sickness symptoms. However, although this device might be suitable for passive transportation, the continued deterioration in performance measures indicates that it provides no significant advantage for personnel engaged in the active operation of modern vessels.

  12. Sickness Behaviour: Causes and Effects | Viljoen | South African ...

    African Journals Online (AJOL)

    This paper discusses sickness behaviour as a central motivational state. It deals with the adaptational value and underlying mechanisms of sickness behaviour and with the consequences of the body's failure to terminate the activity of the symptoms-producing cytokines. SA Fam Pract 2003;45(10):15-18 ...

  13. Identifying workers at risk of sickness absence by questionnaire

    NARCIS (Netherlands)

    Roelen, Corne A. M.; van der Pol, Tjepke R.; Koopmans, Petra C.; Groothoff, Johan W.


    Background Sickness absence is an important economic problem, because of high costs and lost productivity. Determining factors associated with increased risk of sickness absence may lead to the development of preventive measures. Aims To determine whether self-report questionnaires can identify

  14. Current problems of prevention diagnosis and treatment of radiation sickness

    International Nuclear Information System (INIS)

    Gus'kova, A.K.


    Causes of increasing interest to the problems of prevention, diagnosis and treatment of radiation sickness are presented. On the basis of recent publications some new aspects as quantitative criteria in radiobiology, organization problems of medical aid at radiation incidents estimation of efficiency of preventive medicine and radiation sickness therapy, theoretical development of radiotherapy of different organs et al., are characterized

  15. Subjective health complaints in relation to sickness absence

    NARCIS (Netherlands)

    Roelen, Corne A. M.; Koopmans, Petra C.; Groothoff, Johan W.


    Objective: The Dutch population is healthy in terms of living and working conditions, but the levels of subjective health complaints (SHC) and sickness absence are high in the Dutch workforce. Are SHC related to sickness absence? Participants: The study population included the personnel of four

  16. Avoidable sickness absence in a dutch working population

    NARCIS (Netherlands)

    Kremer, A.M.; Steenbeek, R.


    Introduction Sickness absence has an important impact on employers (e.g. reduced productivity, high costs) and employees (e.g. replacement, job loss). Therefore, we investigated possible reduction by exploring avoidable sickness absence. Methods A questionnaire was filled out by 2,954 Dutch workers

  17. [Vestibular testing abnormalities in individuals with motion sickness]. (United States)

    Ma, Yan; Ou, Yongkang; Chen, Ling; Zheng, Yiqing


    To evaluate the vestibular function of motion sickness. VNG, which tests the vestibular function of horizontal semicircular canal, and CPT, which tests vestibulospinal reflex and judge proprioceptive, visual and vestibular status, were performed in 30 motion sickness patients and 20 healthy volunteers (control group). Graybiel score was recorded at the same time. Two groups' Graybiel score (12.67 +/- 11.78 vs 2.10 +/- 6.23; rank test P<0.05), caloric test labyrinth value [(19.02 +/- 8.59) degrees/s vs (13.58 +/- 5.25) degrees/s; t test P<0.05], caloric test labyrinth value of three patients in motion sickness group exceeded 75 degrees/s. In computerized posturography testing (CPT), motion sickness patients were central type (66.7%) and disperse type (23.3%); all of control group were central type. There was statistical significance in two groups' CTP area, and motion sickness group was obviously higher than control group. While stimulating vestibulum in CPT, there was abnormality (35%-50%) in motion sickness group and none in control group. Generally evaluating CPT, there was only 2 proprioceptive hypofunction, 3 visual hypofunction, and no vestibular hypofunction, but none hypofunction in control group. Motion sickness patients have high vestibular susceptible, some with vestibular hyperfunction. In posturography, a large number of motion sickness patients are central type but no vestibular hypofunction, but it is hard to keep balance when stimulating vestibulum.

  18. Sickness absence frequency among women working in hospital care

    NARCIS (Netherlands)

    Roelen, Corne A. M.; Schreuder, Jolanda A. H.; Koopmans, Petra C.; Moen, Bente E.; Groothoff, Johan W.


    Background Frequent short sickness absences result in understaffing and interfere with work processes. We need more knowledge about factors associated with this type of absence. Aims To investigate associations between the frequency of previous sickness absence and self-reported perceptions of

  19. Suggested classification of acute radiation sickness

    Energy Technology Data Exchange (ETDEWEB)

    Yao, Guo; Mingyue, Zhu; Zhiqin, Zhao


    Acute radiation sickness is usually classified into three types. Over the last decade, we have been engaged in experimental studies on the classification of this syndrome. Our findings from these studies, however, point to the fact that between the hemopoietic and intestinal types, and between the intestinal and cerebral types there are transitive forms, namely, hemopoieto-intestinal type and cardio-vascular type, respectively. In this article the required radiation doses and the clinical courses of these transitive forms with special emphasis on their histological and clinical manifestations are described. In case of the hemopoieto-intestinal form, histological examination may reveal residual crypts and typical ''abnormal cells'' in the intestinal mucosa, and clinical manifestations include almost the whole spectrum of symptoms and signs of infection and hemorrhage. The watery stool in pink colour may be specific and helpful in diagnosis. In case of the cardio-vascular form, shock may occur immediately after exposure, and histological examination may show myocardial edema, hemorrhage, cell-infiltration and even necrosis. We propose that the acute radiation sickness should be divided into 5 forms, namely, hemopoietic, hemopoieto-intestinal, intestinal, cardio-vascular and cerebral types. Accurate diagnosis can only be made by taking an comprehensive view of radiation dose, clinical course, clinical manifestations and histological findings. (author).

  20. A suggested classification of acute radiation sickness

    International Nuclear Information System (INIS)

    Guo Yao; Zhu Mingyue; Zhao Zhiqin


    Acute radiation sickness is usually classified into three types. Over the last decade, we have been engaged in experimental studies on the classification of this syndrome. Our findings from these studies, however, point to the fact that between the hemopoietic and intestinal types, and between the intestinal and cerebral types there are transitive forms, namely, hemopoieto-intestinal type and cardio-vascular type, respectively. In this article the required radiation doses and the clinical courses of these transitive forms with special emphasis on their histological and clinical manifestations are described. In case of the hemopoieto-intestinal form, histological examination may reveal residual crypts and typical ''abnormal cells'' in the intestinal mucosa, and clinical manifestations include almost the whole spectrum of symptoms and signs of infection and hemorrhage. The watery stool in pink colour may be specific and helpful in diagnosis. In case of the cardio-vascular form, shock may occur immediately after exposure, and histological examination may show myocardial edema, hemorrhage, cell-infiltration and even necrosis. We propose that the acute radiation sickness should be divided into 5 forms, namely, hemopoietic, hemopoieto-intestinal, intestinal, cardio-vascular and cerebral types. Accurate diagnosis can only be made by taking an comprehensive view of radiation dose, clinical course, clinical manifestations and histological findings. (author)

  1. Late stage infection in sleeping sickness.

    Directory of Open Access Journals (Sweden)

    Hartwig Wolburg

    Full Text Available At the turn of the 19(th century, trypanosomes were identified as the causative agent of sleeping sickness and their presence within the cerebrospinal fluid of late stage sleeping sickness patients was described. However, no definitive proof of how the parasites reach the brain has been presented so far. Analyzing electron micrographs prepared from rodent brains more than 20 days after infection, we present here conclusive evidence that the parasites first enter the brain via the choroid plexus from where they penetrate the epithelial cell layer to reach the ventricular system. Adversely, no trypanosomes were observed within the parenchyma outside blood vessels. We also show that brain infection depends on the formation of long slender trypanosomes and that the cerebrospinal fluid as well as the stroma of the choroid plexus is a hostile environment for the survival of trypanosomes, which enter the pial space including the Virchow-Robin space via the subarachnoid space to escape degradation. Our data suggest that trypanosomes do not intend to colonize the brain but reside near or within the glia limitans, from where they can re-populate blood vessels and disrupt the sleep wake cycles.

  2. The study of thrombocytopenia in sick neonates

    International Nuclear Information System (INIS)

    Aman, I.; Hassan, K.A.; Ahmad, T.M.


    Objective: To determine the number of cases and manifestations of thrombocytopenia in sick neonates. Subjects and Methods: A total of 365 neonates from 0-28 days of age admitted with different clinical problems irrespective of birth weight and gestational age were evaluated for thrombocytopenia. These neonates were categorized into five different groups (A-E), which were of neonatal infections, asphyxia neonatorum, preterm and smallness for gestational age, jaundice and miscellaneous respectively. Results: Out of 365 cases, 88 were found to have thrombocytopenia (platelet counts < 150,000 per mm/sup 3/) which was 24.1% of the total. In group A (neonatal infections), out of 152 neonates, 62 had low platelet counts (40.78%). In group B (neonatal asphyxia), out of 90 only 11 had thrombocytopenia (12.2%). In group C (preterm and small for gestational age), out of 60 cases only 9 had thrombocytopenia. In group D (jaundice), all 33 cases had normal platelet counts. In group E (miscellaneous), out of 30 cases only 6 had thrombocytopenia. The common manifestations in thrombocytopenic babies were petechiae and bruises followed by gastrointestinal hemorrhages. The percentage of manifest thrombocytopenia cases was 56.8% and of occult thrombocytopenia 43.1 %. Conclusion: The leading causes of thrombocytopenia in sick neonates are infections, asphyxia, complicated pre- maturity and smallness for gestational age. Apart from the platelet counts the bleeding mainfestations also depend upon the underlying ailments. (author)

  3. Effect of domperidone on radiation sickness

    Energy Technology Data Exchange (ETDEWEB)

    Sakakibara, T; Sato, K [Nihon Univ., Tokyo. School of Medicine; Watari, T; Tanaka, T; Furuta, A


    Domperidone was administered to 95 patients with radiation sickness following radiotherapy for various cancers. The chest and the mediastinum were irradiated in 43 patients, the upper and lower abdomen in 40 patients, and the head, neck, and supraclavicular region in 12 patients. As to radiation source, x-ray was used for 46 patients, ..gamma..-ray for 41 patients, electron beam for 3 patients, and more than one radiation was used for 5 patients. The dose given before the onset of radiation sickness totaled 3000 rad in 20 patients, 1000 rad -- 3000 rad in 41, and less than 1000 rad in 34. Domperidone was given to the patients one tablet (5 mg or 10 mg) P.O., 3 times per day before meals, for 1 -- 2 weeks. The overall effective rate of the drug was 68.4%. The 10 mg tablets were slightly more effective than the 5 mg ones. In the patients who were given the drug in a dose of 10 mg, the ameliorating rate of subjective symptoms was 68.1% for nausea, 88.9% for vomiting, 44.6% for anorexia, 17.5% for general fatigue, and 69.2% for dizziness. Laboratory findings showed no abnormal effects of the drug. One patient had itching with eruptions, which, however, was mild and disappeared immediately after withdrawal of the medication.

  4. Teflon granulomas mimicking cerebellopontine angle tumors following microvascular decompression. (United States)

    Deep, Nicholas L; Graffeo, Christopher S; Copeland, William R; Link, Michael J; Atkinson, John L; Neff, Brian A; Raghunathan, Aditya; Carlson, Matthew L


    To report two patients with a history of microvascular decompression (MVD) for hemifacial spasm who presented with Teflon granulomas (TG) mimicking cerebellopontine angle (CPA) tumors and to perform a systematic review of the English-language literature. Case series at a single tertiary academic referral center and systematic review. Retrospective chart review with analysis of clinical, radiological, and histopathological findings. Systematic review using PubMed, Embase, MEDLINE, and Web of Science databases. Two patients with large skull base TGs mimicking CPA tumors clinically and radiographically were managed at the authors' institution. The first presented 4 years after MVD with asymmetrical sensorineural hearing loss, multiple progressive cranial neuropathies, and brainstem edema due to a growing TG. Reoperation with resection of the granuloma confirmed a foreign-body reaction consisting of multinucleated giant cells containing intracytoplasmic Teflon particles. The second patient presented 11 years after MVD with asymmetrical sensorineural hearing loss and recurrent hemifacial spasm. No growth was noted over 2 years, and the patient has been managed expectantly. Only one prior case of TG after MVD for hemifacial spasm has been reported in the English literature. TG is a rare complication of MVD for hemifacial spasm. The diagnosis should be suspected in patients presenting with a new-onset enhancing mass of the CPA after MVD, even when performed decades earlier. A thorough clinical and surgical history is critical toward establishing an accurate diagnosis to guide management and prevent unnecessary morbidity. Surgical intervention is not required unless progressive neurologic complications ensue. 4 Laryngoscope, 127:715-719, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  5. Persistent hemifacial spasm after microvascular decompression: a risk assessment model. (United States)

    Shah, Aalap; Horowitz, Michael


    Microvascular decompression (MVD) for hemifacial spasm (HFS) provides resolution of disabling symptoms such as eyelid twitching and muscle contractions of the entire hemiface. The primary aim of this study was to evaluate the predictive value of patient demographics and spasm characteristics on long-term outcomes, with or without intraoperative lateral spread response (LSR) as an additional variable in a risk assessment model. A retrospective study was undertaken to evaluate the associations of pre-operative patient characteristics, as well as intraoperative LSR and need for a staged procedure on the presence of persistent or recurrent HFS at the time of hospital discharge and at follow-up. A risk assessment model was constructed with the inclusion of six clinically or statistically significant variables from the univariate analyses. A receiving operator characteristic curve was generated, and area under the curve was calculated to determine the strength of the predictive model. A risk assessment model was first created consisting of significant pre-operative variables (Model 1) (age >50, female gender, history of botulinum toxin use, platysma muscle involvement). This model demonstrated borderline predictive value for persistent spasm at discharge (AUC .60; p=.045) and fair predictive value at follow-up (AUC .75; p=.001). Intraoperative variables (e.g. LSR persistence) demonstrated little additive value (Model 2) (AUC .67). Patients with a higher risk score (three or greater) demonstrated greater odds of persistent HFS at the time of discharge (OR 1.5 [95%CI 1.16-1.97]; p=.035), as well as greater odds of persistent or recurrent spasm at the time of follow-up (OR 3.0 [95%CI 1.52-5.95]; p=.002) Conclusions: A risk assessment model consisting of pre-operative clinical characteristics is useful in prognosticating HFS persistence at follow-up.

  6. Supraorbital keyhole surgery for optic nerve decompression and dura repair. (United States)

    Chen, Yuan-Hao; Lin, Shinn-Zong; Chiang, Yung-Hsiao; Ju, Da-Tong; Liu, Ming-Ying; Chen, Guann-Juh


    Supraorbital keyhole surgery is a limited surgical procedure with reduced traumatic manipulation of tissue and entailing little time in the opening and closing of wounds. We utilized the approach to treat head injury patients complicated with optic nerve compression and cerebrospinal fluid leakage (CSF). Eleven cases of basal skull fracture complicated with either optic nerve compression and/or CSF leakage were surgically treated at our department from February 1995 to June 1999. Six cases had primary optic nerve compression, four had CSF leakage and one case involved both injuries. Supraorbital craniotomy was carried out using a keyhole-sized burr hole plus a small craniotomy. The size of craniotomy approximated 2 x 3 cm2. The optic nerve was decompressed via removal of the optic canal roof and anterior clinoid process with high-speed drills. The defect of dura was repaired with two pieces of tensa fascia lata that were attached on both sides of the torn dural defect with tissue glue. Seven cases with optic nerve injury included five cases of total blindness and two cases of light perception before operation. Vision improved in four cases. The CSF leakage was stopped successfully in all four cases without complication. As optic nerve compression and CSF leakage are skull base lesions, the supraorbital keyhole surgery constitutes a suitable approach. The supraorbital keyhole surgery allows for an anterior approach to the skull base. This approach also allows the treatment of both CSF leakage and optic nerve compression. Our results indicate that supraorbital keyhole operation is a safe and effective method for preserving or improving vision and attenuating CSF leakage following injury.

  7. Parental availability for the care of sick children. (United States)

    Heymann, S J; Earle, A; Egleston, B


    Parents have always played a critical role in the care of sick children. Although parents' roles remain crucial to children's health, parental availability has declined during the past half century. The percentage of women with preschool children who work has risen almost fivefold in 45 years from 12% in 1947 to 58% in 1992. The percentage of women in the paid work force with school-aged children has almost tripled in the same period, from 27.3% to 75.9%. Research has examined the effects of a variety of parental work conditions on children. However, past research has not examined how working conditions affect the ability of parents to care for their sick children. In this article, we examine how often the children of working parents get sick and whether parents receive enough paid leave to care for their sick children. This analysis makes use of two national surveys, which provide complementary information regarding the care of sick children. The National Longitudinal Survey of Youth is a longitudinal survey of a nationally representative probability sample of 12,686 men and women; the National Medical Expenditure Survey is a panel survey of 34,459 people. First, we estimated the family illness burden. Second, we looked in detail at the number of days of sick leave mothers had. Third, we examined whether mothers who had sick leave had it consistently during a 5-year period. Finally, we conducted a logistic regression to determine what factors were significant predictors of both lacking sick leave. More than one in three families faced a family illness burden of 2 weeks or more each year. Yet, 28% of mothers had sick leave none of the time they were employed between 1985 and 1990. Employed mothers of children with chronic conditions had less sick leave than other employed mothers. Thirty-six percent of mothers whose children had chronic conditions had sick leave none of the time they were employed. Although 20% of working parents who did not live in poverty lacked

  8. Analyzing sickness absence with statistical models for survival data

    DEFF Research Database (Denmark)

    Christensen, Karl Bang; Andersen, Per Kragh; Smith-Hansen, Lars


    OBJECTIVES: Sickness absence is the outcome in many epidemiologic studies and is often based on summary measures such as the number of sickness absences per year. In this study the use of modern statistical methods was examined by making better use of the available information. Since sickness...... absence data deal with events occurring over time, the use of statistical models for survival data has been reviewed, and the use of frailty models has been proposed for the analysis of such data. METHODS: Three methods for analyzing data on sickness absences were compared using a simulation study...... involving the following: (i) Poisson regression using a single outcome variable (number of sickness absences), (ii) analysis of time to first event using the Cox proportional hazards model, and (iii) frailty models, which are random effects proportional hazards models. Data from a study of the relation...

  9. Explanation of diagnosis criteria for radiation sickness from internal exposure

    International Nuclear Information System (INIS)

    Xing Zhiwei; Jiang Enhai; Du Jianying; Bai Guang


    A revised edition of the Diagnostic Criteria for Radiation Sickness from Internal Exposure has been approved and issued by the Ministry of Health. It is necessary to research the internal radiation sickness to adapt to the current serious anti-terrorism situation. This standard was enacted based on the extensive research of related literature, from which 12 cases with internal radiation sickness and screened out were involving 7 types of radionuclide. The Development of Emergency Response Standard Extension Framework: Midterm Evaluation Report is the main reference which approved by the International Atomic Energy Agency and World Health Organization. This amendment contains many new provisions such as internal radiation sickness effects models and threshold dose, and the appendix added threshold dose of serious deterministic effects induced by radionuclide intake and radiotoxicology parameters of some radionuclides. In order to understand and implement this standard, and to diagnose and treat the internal radiation sickness correctly, the contents of this standard were interpreted in this article. (authors)

  10. Sickness benefit cuts mainly affect blue-collar workers. (United States)

    Aaviksoo, E; Kiivet, R-A


    To analyse the impact of sick-pay cuts on the use of sickness absence by employees of different socioeconomic groups. In 2009 cuts in sick pay were implemented in reaction to an economic crisis in Estonia. Nationwide health survey data from the years 2004, 2006, 2008, and 2010 were used to evaluate sickness absence among blue-collar and white-collar workers. The dataset comprised 7,449 employees of 20-64 years of age. Difference in prevalence of absentees before and after the reform was assessed using the chi-squared test. Odds ratios (OR) for sickness absence were calculated in a multivariate logistic regression model. After the reform, the proportion of blue-collar workers who had been on sick leave decreased from 51% to 40% (pgender, age, self-rated health, and presence of chronic disease, especially among those with low incomes; in white-collar employees it reached statistical significance only in those with good self-rated health (p=0.033). In a multivariate model the odds of having lower sickness absence were highly significant only in blue-collar employees (OR 0.63; 95% confidence interval 0.51-0.77, p<0.001). The cuts in sickness benefits had a major impact on the use of sickness absence by blue-collar employees with low salaries. This indicates that lower income was a major factor hindering the use of sick leave as these employees are most vulnerable to the loss of income. © 2014 the Nordic Societies of Public Health.

  11. How physicians have learned to handle sickness-certification cases. (United States)

    Löfgren, Anna; Silén, Charlotte; Alexanderson, Kristina


    Sickness absence is a common ''prescription'' in health care in many Western countries. Despite the significance of sick-listing for the life situation of patients, physicians have limited training in how to handle sickness-certification cases and the research about sickness-certification practices is scarce. Gain knowledge on physicians' learning regarding management of sickness certification of patients in formal, informal, and non-formal learning situations, respectively, and possible changes in this from 2004 to 2008. Data from two comprehensive questionnaires to physicians in Sweden about their sickness-certification practice in 2004 (n = 7665) and 2008 (n = 36,898); response rates: 71% and 61%, respectively. Answers from all the physicians ≤64 years old and who had sickness certification tasks (n = 4019 and n = 14,210) were analysed. ratings of importance of different types of learning situations for their sickness-certification competence. Few physicians stated that formal learning situations had contributed to a large or fairly large extent to their competence in sickness certification, e.g. undergraduate studies had done that for 17%, internship for 37%, and resident training for 46%, respectively. Contacts with colleagues had been helpful for 65%. One-third was helped by training arranged by social insurance offices. There was a significant increase between 2004 and 2008 in all items related to formal and non-formal learning situations, while there were no changes regarding informal learning situations. This study of all physicians in Sweden shows that physicians primarily attain competence in sickness certification in their daily clinical practice; through contacts with colleagues and patients.

  12. Medically certified sickness absence among health care workers. (United States)

    Khawaja, Rajab Ali; Sikander, Raheel; Khawaja, Asad Ali; Jareno, Rechel Joy Macadaan; Halepota, Aurangzeb Taj


    To compare the days and spells of sickness absence among males versus females and Saudi nationals versus expatriate employees of King Khalid University Hospital, Riyadh, and to identify the cause of sickness absence. The cross-sectional, descriptive study comprised 3117 King Khalid University Hospital employees. Records of physician-certified sickness absence from January 1 to June 30, 2009, were obtained from the employee health clinic's register. Absence rate, frequency, duration and severity were assessed and compared between genders and nationalities, and causes were noted. SPSS version 16 and student's t test were used for statistical analyses and comparison. A total of 377 (12.1 %) employees had 416 spells of sickness absence with 639 sick-off days (mean: 1.54 +/- 0.85). The probability of sickness absence was higher among Saudi (OR=1.33) and female (OR=1.39) employees. The association of sickness absence was not found among the absentees with either gender (p= 0.335) or nationality (p = 0.086). Almost all spells of sick-off days were of short duration. Longer spells were mainly due to chicken pox which was found to be more among the expatriates. Heavy absenteeism was found only among the Saudis. The most common causes of sickness absence were acute upper respiratory infection, diseases of musculoskeletal system and the digestive system. The rate, frequency and duration of absence due to sickness in the study were higher among Saudi and female employees. The rate of absence, with passage of time, has increased significantly among Saudi nationals.

  13. Outcome after decompressive craniectomy for the treatment of severe traumatic brain injury. (United States)

    Howard, Jerry Lee; Cipolle, Mark D; Anderson, Meredith; Sabella, Victoria; Shollenberger, Daniele; Li, P Mark; Pasquale, Michael D


    Using decompressive craniectomy as part of the treatment regimen for severe traumatic brain injury (STBI) has become more common at our Level I trauma center. This study was designed to examine this practice with particular attention to long-term functional outcome. A retrospective review of prospectively collected data was performed for patients with STBI admitted from January 1, 2003 to December 31, 2005. Our institution manages patients using the Brain Trauma Foundation Guidelines. Data collected from patients undergoing decompressive craniectomy included: age, Injury Severity Score, admission and follow-up Glasgow Coma Score, timing of, and indication for decompressive craniectomy, and procedure-related complications. The Extended Glasgow Outcome Scale (GOSE) was performed by a experienced trauma clinical research coordinator using a structured phone interview to assess long-term outcome in the survivors. Student's t test and chi2 were used to examine differences between groups. Forty STBI patients were treated with decompressive craniectomy; 24 were performed primarily in conjunction with urgent evacuation of extra-axial hemorrhage and 16 were performed primarily in response to increased intracranial pressure with 4 of these after an initial craniotomy. Decompressive craniectomy was very effective at lowering intracranial pressure in these 16 patients (35.0 mm Hg +/- 13.5 mm Hg to 14.6 mm Hg +/- 8.7 mm Hg, p = 0.005). Twenty-two decompressive craniectomy patients did not survive to hospital discharge, whereas admission Glasgow Coma Score and admission pupil size and reactivity correlated with outcome, age, and Injury Severity Score did not. At a mean of 11 months (range, 3-26 months) after decompressive craniectomy, 6 survivors had a poor functional outcome (GOSE 1-4), whereas 12 survivors had a good outcome (GOSE 5-8). Therefore, 70% of these patients had an unfavorable outcome (death or severe disability), and 30% had a favorable long-term functional outcome

  14. "White Cord Syndrome" of Acute Hemiparesis After Posterior Cervical Decompression and Fusion for Chronic Cervical Stenosis. (United States)

    Antwi, Prince; Grant, Ryan; Kuzmik, Gregory; Abbed, Khalid


    "White cord syndrome" is a very rare condition thought to be due to acute reperfusion of chronically ischemic areas of the spinal cord. Its hallmark is the presence of intramedullary hyperintense signal on T2-weighted magnetic resonance imaging sequences in a patient with unexplained neurologic deficits following spinal cord decompression surgery. The syndrome is rare and has been reported previously in 2 patients following anterior cervical decompression and fusion. We report an additional case of this complication. A 68-year-old man developed acute left-sided hemiparesis after posterior cervical decompression and fusion for cervical spondylotic myelopathy. The patient improved with high-dose steroid therapy. The rare white cord syndrome following either anterior cervical decompression and fusion or posterior cervical decompression and fusion may be due to ischemic-reperfusion injury sustained by chronically compressed parts of the spinal cord. In previous reports, patients have improved following steroid therapy and acute rehabilitation. Copyright © 2018 Elsevier Inc. All rights reserved.

  15. Optic neuropathy in thyroid eye disease: results of the balanced decompression technique. (United States)

    Baril, Catherine; Pouliot, Denis; Molgat, Yvonne


    To determine the efficacy of combined endoscopic medial and external lateral orbital decompression for the treatment of compressive optic neuropathy (CON) in thyroid eye disease (TED). A retrospective review of all patients undergoing combined surgical orbital decompression for CON between 2000 and 2010 was conducted. Fifty-nine eyes of 34 patients undergoing combined surgical orbital decompression for CON. Clinical outcome measures included visual acuity, Hardy-Rand-Rittler (HRR) colour plate testing, relative afferent pupillary defect, intraocular pressure measurement, and Hertel exophthalmometry. A CON score was calculated preoperatively and postoperatively based on the visual acuity and the missed HRR plates. A higher CON score correlates with more severe visual dysfunction. All patients had improvement of their optic neuropathy after surgical decompression. CON score was calculated for 54 eyes and decreased significantly from a mean of 13.2 ± 10.35 preoperatively to a mean of 8.51 ± 10.24 postoperatively (p < 0.0001). Optic neuropathy was completely resolved in 93.22% (55/59 eyes). Eighteen of 34 patients (52.94%) experienced development of new-onset postoperative strabismus that required subsequent surgical intervention. Endoscopic medial combined with external lateral orbital decompression is an effective technique for the treatment of TED-associated CON. © 2013 Canadian Ophthalmological Society Published by Canadian Ophthalmological Society All rights reserved.

  16. A comparative study of the intracranial environment before and after cranioplasty in decompressive craniectamized cases

    International Nuclear Information System (INIS)

    Utsugi, Osamu; Saito, Fumio; Inaba, Izumi; Takeda, Yasuaki; Miki, Tamotsu; Miwa, Tetsurou


    The external decompression is performed as a secondary method for the surgical treatment of increased intracranial pressure due to trauma or cerebrovascular disease. We have had the experience that, if patients are kept in a decompressed state for a prolonged period, they often complain of various minor neurological disorders; cranioplasty done on such patients improves those disorders. In this investigation, the authors made a plan to elucidate this mechanism. The subjects were 30 cases of non-progressive diseases, such as postoperative lesions of ruptured aneurysms, and intracerebral hematomas. We proved that the cerebral function improves after the cranioplasty by an average score of 5.7 on Hasegawa's simple intelligent evaluation scale and by 88.9% in EEG. The morphological change was observed by a CT scan, which showed as a compressive deformity of the lateral ventricle, subdural fluid collection, and a prolonged residue of brain edema. These findings were rapidly and greatly improved after the cranioplasty. It was also found, by the measurement of the regional cerebral blood flow by means of SPECT, that the hemicerebral blood flow rate on the side of the decompressive craniectomy was significantly improved after the cranioplasty compared with the control group. From the above data, it was presumed that the persistence of neurological disorders in decompressive craniectomy is caused largely by a regional cerebral blood flow disorder. Therefore, the authors considered that, when external decompression is done, it is essential to perform cranioplasty as soon as possible after the intracranial pressure has been relieved. (author)

  17. Complicated Pseudomeningocele Repair After Chiari Decompression: Case Report and Review of the Literature. (United States)

    De Tommasi, Claudio; Bond, Aaron E


    Pseudomeningocele is a recognised complication after posterior fossa decompression for Chiari malformation. Its management can be challenging and treatment options vary in literature. A difficult-to-treat case of a pseudomeningocele after posterior fossa decompression for a Chiari I malformation is presented. A 34-year-old woman underwent an initial decompression followed by multiple revision surgeries after the development of a symptomatic pseudomeningocele and a low-grade infection. Complications associated with standard treatment modalities, including lumbar drainage and dural repair, are discussed. A review of the existing literature is presented. The reported case ultimately required complete removal of all dural repair materials to eliminate the patient's low-grade infection, a muscular flap, and placement of a ventricular-peritoneal shunt for definitive treatment after a trial of a lumbar drain led to herniation and development of a syrinx. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. General Purpose Graphics Processing Unit Based High-Rate Rice Decompression and Reed-Solomon Decoding

    Energy Technology Data Exchange (ETDEWEB)

    Loughry, Thomas A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)


    As the volume of data acquired by space-based sensors increases, mission data compression/decompression and forward error correction code processing performance must likewise scale. This competency development effort was explored using the General Purpose Graphics Processing Unit (GPGPU) to accomplish high-rate Rice Decompression and high-rate Reed-Solomon (RS) decoding at the satellite mission ground station. Each algorithm was implemented and benchmarked on a single GPGPU. Distributed processing across one to four GPGPUs was also investigated. The results show that the GPGPU has considerable potential for performing satellite communication Data Signal Processing, with three times or better performance improvements and up to ten times reduction in cost over custom hardware, at least in the case of Rice Decompression and Reed-Solomon Decoding.

  19. Risk Associated With The Decompression Of High Pressure High Temperature Fluids - Study On Black Oil

    DEFF Research Database (Denmark)

    Figueroa, D. C.; Fosbøl, P. L.; Thomsen, K.


    Fluids produced from deep underground reservoirs may result in exponential increase in temperature. It is a consequence of adiabatic fluid decompression from the inverse Joule Thomson Effect (JTE). The phenomenon requires analysis in order to avoid any operational risks. This study evaluates...... the JTE upon decompression of black oil in high pressure-high temperature reservoirs. Also the effect caused by the presence of water and brine on the black oil is studied. The final temperature is calculated from the corresponding energy balance at isenthalpic and non-isenthalpic conditions. It is found...... that the final temperature of black oil increases upon adiabatic decompression. In the case of the isenthalpic process at initial conditions of the reservoir, e.g. 150°C and 1000 bars, it is found that the final temperature can increase to 173.7°C. At non-isenthalpic conditions the final temperature increases...

  20. Prognostic Factors for Satisfaction After Decompression Surgery for Lumbar Spinal Stenosis

    DEFF Research Database (Denmark)

    Paulsen, Rune Tendal; Bouknaitir, Jamal Bech; Fruensgaard, Søren


    : To present clinical outcome data and identify prognostic factors related to patient satisfaction 1 yr after posterior decompression surgery for lumbar spinal stenosis. METHOD: This multicenter register study included 2562 patients. Patients were treated with various types of posterior decompression. Patients...... with previous spine surgery or concomitant fusion were excluded. Patient satisfaction was analyzed for associations with age, sex, body mass index, smoking status, duration of pain, number of decompressed vertebral levels, comorbidities, and patient-reported outcome measures, which were used to quantify....... CONCLUSION: This study found smoking, long duration of leg pain, and cancerous and neurological disease to be associated with patient dissatisfaction, whereas good walking capacity at baseline was positively associated with satisfaction after 1 yr....

  1. MRI-guidance in percutaneous core decompression of osteonecrosis of the femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Kerimaa, Pekka; Vaeaenaenen, Matti; Ojala, Risto; Tervonen, Osmo; Blanco Sequeiros, Roberto [Oulu University Hospital, Department of Radiology (Finland); Hyvoenen, Pekka; Lehenkari, Petri [Oulu University Hospital, Department of Surgery (Finland)


    The purpose of this study was to evaluate the usefulness of MRI-guidance for core decompression of avascular necrosis of the femoral head. Twelve MRI-guided core decompressions were performed on patients with different stages of avascular necrosis of the femoral head. The patients were asked to evaluate their pain and their ability to function before and after the procedure and imaging findings were reviewed respectively. Technical success in reaching the target was 100 % without complications. Mean duration of the procedure itself was 54 min. All patients with ARCO stage 1 osteonecrosis experienced clinical benefit and pathological MRI findings were seen to diminish. Patients with more advanced disease gained less, if any, benefit and total hip arthroplasty was eventually performed on four patients. MRI-guidance seems technically feasible, accurate and safe for core decompression of avascular necrosis of the femoral head. Patients with early stage osteonecrosis may benefit from the procedure. (orig.)

  2. MRI-guidance in percutaneous core decompression of osteonecrosis of the femoral head

    International Nuclear Information System (INIS)

    Kerimaa, Pekka; Vaeaenaenen, Matti; Ojala, Risto; Tervonen, Osmo; Blanco Sequeiros, Roberto; Hyvoenen, Pekka; Lehenkari, Petri


    The purpose of this study was to evaluate the usefulness of MRI-guidance for core decompression of avascular necrosis of the femoral head. Twelve MRI-guided core decompressions were performed on patients with different stages of avascular necrosis of the femoral head. The patients were asked to evaluate their pain and their ability to function before and after the procedure and imaging findings were reviewed respectively. Technical success in reaching the target was 100 % without complications. Mean duration of the procedure itself was 54 min. All patients with ARCO stage 1 osteonecrosis experienced clinical benefit and pathological MRI findings were seen to diminish. Patients with more advanced disease gained less, if any, benefit and total hip arthroplasty was eventually performed on four patients. MRI-guidance seems technically feasible, accurate and safe for core decompression of avascular necrosis of the femoral head. Patients with early stage osteonecrosis may benefit from the procedure. (orig.)

  3. Outcomes of decompressive craniectomy in patients after traumatic brain injury. (United States)

    Nambiar, Mithun; MacIsaac, Christopher; Grabinski, Rafal; Liew, Danny; Kavar, Bhadrakant


    Traumatic brain injury (TBI) can result in cerebral oedema and vascular changes resulting in an increase in intracranial pressure (ICP), which can lead to further secondary damage. Decompressive craniectomy (DC) is a surgical option in the management of ICP. We aimed to investigate outcomes of DC after TBI. We performed a retrospective audit of 57 adult patients (aged > 15 years) who underwent DC after TBI, at the Royal Melbourne Hospital from 1 January 2005 to 30 June 2011. Our functional outcome measure was the Extended Glasgow Outcome Scale (GOSE). Patients had a median age of 30 years (range, 17- 73 years). The hospital mortality rate was 47% (27 patients). A higher postoperative median ICP was the most significant predictor of hospital mortality (OR, 1.1; 95% CI, 1-1.3). There was a mean decrease of 7.7mmHg in ICP between the mean preoperative and postoperative ICP values (95% CI, - 10.5 to - 5.0mmHg). There was a mean decrease of 3.5mmHg in the mean cerebral perfusion pressure (CPP) from preoperative to postoperative CPP values (95% CI, - 6.2 to - 0.8mmHg). At the 6-month follow-up, a poor outcome (GOSE score, 1-4) was seen in 39 patients (68%), while a good outcome (GOSE score, 5- 8) was noted in 15 patients (26%). A high APACHE II score on admission was the most significant predictor of a worse GOSE score at 6 months (OR, 1.3; 95% CI, 1.1-1.5). Analysis of the APACHE II and IMPACT scores as models for predicting mortality at 6 months showed an area under the curve (AUC) of 0.792 and 0.805, respectively, and for predicting poor outcome at 6 months, showed an AUC of 0.862 and 0.883, respectively. DC decreased ICP postoperatively. The IMPACT and APACHE II scores are good models for prediction of death and poor outcome at 6 months.

  4. Experimental Evidence of Low Density Liquid Water under Decompression (United States)

    Shen, G.; Lin, C.; Sinogeikin, S. V.; Smith, J.


    Water is not only the most important substance for life, but also plays important roles in liquid science for its anomalous properties. It has been widely accepted that water's anomalies are not a result of simple thermal fluctuation, but are connected to the formation of various structural aggregates in the hydrogen bonding network. Among several proposed scenarios, one model of fluctuations between two different liquids has gradually gained traction. These two liquids are referred to as a low-density liquid (LDL) and a high-density liquid (HDL) with a coexistence line in the deeply supercooled regime at elevated pressure. The LDL-HDL transition ends with decreasing pressure at a liquid-liquid critical point (LLCP) with its Widom line extending to low pressures. Above the Widom line lies mostly HDL which is favored by entropy, while LDL, mostly lying below the Widom line, is favored by enthalpy in the tetrahedral hydrogen bonding network. The origin of water's anomalies can then be explained by the increase in structural fluctuations, as water is cooled down to deeply supercooled temperatures approaching the Widom line. Because both the LLCP and the LDL-HDL transition line lie in water's "no man's land" between the homogeneous nucleation temperature (TH, 232 K) and the crystallization temperature (TX, 150 K), the success of experiments exploring this region has been limited thus far. Using a rapid decompression technique integrated with in situ x-ray diffraction, we observe that a high-pressure ice phase transforms to a low-density noncrystalline (LDN) form upon rapid release of pressure at temperatures of 140-165K. The LDN subsequently crystallizes into ice-Ic through a diffusion-controlled process. The change in crystallization rate with temperature indicates that the LDN is a LDL with its tetrahedrally-coordinated network fully developed and clearly linked to low-density amorphous ices. The observation of the tetrahedral LDL supports the two-liquid model for

  5. Home care services for sick children

    DEFF Research Database (Denmark)

    Castor, Charlotte; Hallström, Inger; Hansson, Eva Helena


    as challenging for healthcare professionals in home care services used to providing care predominately for adults. DESIGN: An inductive qualitative design. METHOD: Seven focus group interviews were performed with 36 healthcare professionals from multidisciplinary home care services. Data were analysed stepwise......AIMS AND OBJECTIVES: To explore healthcare professionals' conceptions of caring for sick children in home care services. BACKGROUND: Families often prefer home care to hospital care, and the number of home care services for children is increasing. Caring for children at home has been recognised...... using a phenomenographic analysis. RESULTS: Three description categories emerged: "A challenging opportunity", "A child perspective", and "Re-organise in accordance with new prerequisites." Providing home care services for children was conceived to evoke both professional and personal challenges...

  6. Motion sickness history, food neophobia, and sensation seeking. (United States)

    Alley, Thomas R; Willet, Kathleen A; Muth, Eric R


    Motion sickness is believed to be caused by conflicting sensory signals, a situation that mimics the effects of ingesting certain toxins. Thus, one might suspect that individuals who have experienced a relatively high frequency of motion sickness may be particularly vigilant about avoiding anything that produces nausea, induding potentially nauseating toxins. Consequently, they may be more resistant to trying new foods, i.e., be more food neophobic, since unfamiliar foods can have unexpected adverse effects due to toxins or allergens. Likewise, many highly stimulating experiences can trigger motion sickness, so individuals who are more susceptible may be more prone to avoid such experiences, i.e., be less sensation seeking. Finally, it was expected that food neophobia would be more frequent in individuals low on sensation seeking tendencies. Self-reported motion sickness history in 308 adults (M= 18.8 yr.; SD = 1.6) was correlated with scores on the Arnett Inventory of Sensation Seeking and the Food Neophobia Scale. As predicted, greater history of motion sickness was associated with lower Sensation Seeking scores. Food Neophobia was not correlated with motion sickness history but, as expected, was negatively correlated (r = -.42) with scores on Sensation Seeking. Further research is recommended that measures actual sensitivity to motion sickness.

  7. Associations between work stress, alcohol consumption and sickness absence. (United States)

    Vasse, R M; Nijhuis, F J; Kok, G


    To test an interactional model on the associations between work stressors, perceived stress, alcohol consumption and sickness absence. Cross-sectional survey. The study was part of a Worksite Health Project including an Employee Assistance Programme and a Health Promotion Programme in the Netherlands. Participants were blue-collar workers from two Municipal Garbage Collecting Departments and white-collar workers from a Pharmaceutical Company (N = 471). Measurements included socio-demographic characteristics (gender, age, education, marital status), work stressors, perceived stress, alcohol consumption and sickness absence. Type of work-site (blue- or white-collar) and smoking behaviour were used as covariates. Regression analyses resulted in three major findings. First, in the presence of stress, abstinence increased the risk of sickness absence compared with moderate drinking. We failed to find a significant relationship between excessive drinking and sickness absence. Secondly, stress mediated the associations between stressor and alcohol consumption, and between stressor and sickness absence, although stressors also directly predicted sickness absence. The association between abstinence and sickness absence could reflect medical problems of abstainers or a lack of skills for coping with stress. The failure to find a significant detrimental effect of excessive drinking may have been due to use of a low threshold for excessive drinking and/or low power. Prospective studies are needed to gain insight in causal relationships between the variables concerned.

  8. Work health determinants in employees without sickness absence. (United States)

    Schell, E; Theorell, T; Nilsson, B; Saraste, H


    Working ability is known to be related to good physical condition, clear work tasks, positive feedback and other occupational, organizational and psychosocial factors. In Sweden, high levels of sickness absence are due to stress-related disorders and musculoskeletal pain. To identify work health characteristics in a working population with a large variety of professional skills and occupational tasks. Employers' data on occupation, sickness absence, age and gender in a working population of 11 occupational groups and questionnaire responses regarding work-organization, environment, work stress, pain, health, and socio-demographic factors were collected. Employees with no history of sick-leave were compared with those with a history of sick-leave (1-182 days, mean 25 days). Of 2641 employees, 1961 participated. Those with no history of sick-leave reported less work-related pain, work-related stress, sleep disturbances, worry about their health, 'sick-presenteeism', monotonous work, bent and twisted working positions and exposure to disturbing noise than those with a history of sick-leave (P health, support from superiors, having influence on their working hours and evening and week-end working, longer working hours per week (P health and less neck, shoulder and back pain and more support from their superiors and influence on their working hours.

  9. Magma decompression rates during explosive eruptions of Kīlauea volcano, Hawaii, recorded by melt embayments (United States)

    Ferguson, David J.; Gonnermann, Helge M.; Ruprecht, Philipp; Plank, Terry; Hauri, Erik H.; Houghton, Bruce F.; Swanson, Donald A.


    The decompression rate of magma as it ascends during volcanic eruptions is an important but poorly constrained parameter that controls many of the processes that influence eruptive behavior. In this study, we quantify decompression rates for basaltic magmas using volatile diffusion in olivine-hosted melt tubes (embayments) for three contrasting eruptions of Kīlauea volcano, Hawaii. Incomplete exsolution of H2O, CO2, and S from the embayment melts during eruptive ascent creates diffusion profiles that can be measured using microanalytical techniques, and then modeled to infer the average decompression rate. We obtain average rates of ~0.05-0.45 MPa s-1 for eruptions ranging from Hawaiian style fountains to basaltic subplinian, with the more intense eruptions having higher rates. The ascent timescales for these magmas vary from around ~5 to ~36 min from depths of ~2 to ~4 km, respectively. Decompression-exsolution models based on the embayment data also allow for an estimate of the mass fraction of pre-existing exsolved volatiles within the magma body. In the eruptions studied, this varies from 0.1 to 3.2 wt% but does not appear to be the key control on eruptive intensity. Our results do not support a direct link between the concentration of pre-eruptive volatiles and eruptive intensity; rather, they suggest that for these eruptions, decompression rates are proportional to independent estimates of mass discharge rate. Although the intensity of eruptions is defined by the discharge rate, based on the currently available dataset of embayment analyses, it does not appear to scale linearly with average decompression rate. This study demonstrates the utility of the embayment method for providing quantitative constraints on magma ascent during explosive basaltic eruptions.

  10. Patient-specific core decompression surgery for early-stage ischemic necrosis of the femoral head.

    Directory of Open Access Journals (Sweden)

    Wei Wang

    Full Text Available Core decompression is an efficient treatment for early stage ischemic necrosis of the femoral head. In conventional procedures, the pre-operative X-ray only shows one plane of the ischemic area, which often results in inaccurate drilling. This paper introduces a new method that uses computer-assisted technology and rapid prototyping to enhance drilling accuracy during core decompression surgeries and presents a validation study of cadaveric tests.Twelve cadaveric human femurs were used to simulate early-stage ischemic necrosis. The core decompression target at the anterolateral femoral head was simulated using an embedded glass ball (target. Three positioning Kirschner wires were drilled into the top and bottom of the large rotor. The specimen was then subjected to computed tomography (CT. A CT image of the specimen was imported into the Mimics software to construct a three-dimensional model including the target. The best core decompression channel was then designed using the 3D model. A navigational template for the specimen was designed using the Pro/E software and manufactured by rapid prototyping technology to guide the drilling channel. The specimen-specific navigation template was installed on the specimen using positioning Kirschner wires. Drilling was performed using a guide needle through the guiding hole on the templates. The distance between the end point of the guide needle and the target was measured to validate the patient-specific surgical accuracy.The average distance between the tip of the guide needle drilled through the guiding template and the target was 1.92±0.071 mm.Core decompression using a computer-rapid prototyping template is a reliable and accurate technique that could provide a new method of precision decompression for early-stage ischemic necrosis.

  11. Early versus Late Decompression for Traumatic Spinal Cord Injuries; a Systematic Review and Meta-analysis

    Directory of Open Access Journals (Sweden)

    Mahmoud Yousefifard


    Full Text Available Introduction: Despite the vast number of surveys, no consensus has been reached on the optimum timing of spinal decompression surgery. This systematic review and meta-analysis aimed to compare the effects of early and late spinal decompression surgery on neurologic improvement and post-surgical complications in patients with traumatic spinal cord injuries.Methods: Two independent reviewers carried out an extended search in electronic databases. Data of neurological outcome and post-surgery complication were extracted. Finally, pooled relative risk (RR with a 95% confidence interval (CI was reported for comparing of efficacy of early and late surgical decompression.Results: Eventually 22 studies were included. The pooled RR was 0.77 (95% CI: 0.68-0.89 for at least one grade neurological improvement, and 0.84 (95% CI: 0.77-0.92 for at least two grade improvement. Pooled RR for surgical decompression performed within 12 hours after the injury was 0.26 (95% CI: 0.13-0.52; p<0.001, while it was 0.75 (95% CI: 0.63-0.90; p=0.002 when the procedure was performed within 24 hours, and 0.93 (95% CI: 0.76-1.14; p=0.48 when it was carried out in the first 72 hours after the injury. Surgical decompression performed within 24 hours after injury was found to be associated with significantly lower rates of post-surgical complications (RR=0.77; 95% CI: 0.68-0.86; p<0.001.Conclusion: The findings of this study indicate that early spinal decompression surgery can improve neurologic recovery and is associated with less post-surgical complications. The optimum efficacy is observed when the procedure is performed within 12 hours of the injury.

  12. Magma decompression rates during explosive eruptions of Kīlauea volcano, Hawaii, recorded by melt embayments (United States)

    Ferguson, David J.; Gonnermann, Helge M.; Ruprecht, Philipp; Plank, Terry; Hauri, Erik H.; Houghton, Bruce F.; Swanson, Donald A.


    The decompression rate of magma as it ascends during volcanic eruptions is an important but poorly constrained parameter that controls many of the processes that influence eruptive behavior. In this study, we quantify decompression rates for basaltic magmas using volatile diffusion in olivine-hosted melt tubes (embayments) for three contrasting eruptions of Kīlauea volcano, Hawaii. Incomplete exsolution of H2O, CO2, and S from the embayment melts during eruptive ascent creates diffusion profiles that can be measured using microanalytical techniques, and then modeled to infer the average decompression rate. We obtain average rates of ~0.05–0.45 MPa s−1 for eruptions ranging from Hawaiian style fountains to basaltic subplinian, with the more intense eruptions having higher rates. The ascent timescales for these magmas vary from around ~5 to ~36 min from depths of ~2 to ~4 km, respectively. Decompression-exsolution models based on the embayment data also allow for an estimate of the mass fraction of pre-existing exsolved volatiles within the magma body. In the eruptions studied, this varies from 0.1 to 3.2 wt% but does not appear to be the key control on eruptive intensity. Our results do not support a direct link between the concentration of pre-eruptive volatiles and eruptive intensity; rather, they suggest that for these eruptions, decompression rates are proportional to independent estimates of mass discharge rate. Although the intensity of eruptions is defined by the discharge rate, based on the currently available dataset of embayment analyses, it does not appear to scale linearly with average decompression rate. This study demonstrates the utility of the embayment method for providing quantitative constraints on magma ascent during explosive basaltic eruptions.

  13. GPs' negotiation strategies regarding sick leave for subjective health complaints. (United States)

    Nilsen, Stein; Malterud, Kirsti; Werner, Erik L; Maeland, Silje; Magnussen, Liv Heide


    To explore general practitioners' (GPs') specific negotiation strategies regarding sick-leave issues with patients suffering from subjective health complaints. Focus-group study. Nine focus-group interviews in three cities in different regions of Norway. 48 GPs (31 men, 17 women; age 32-65), participating in a course dealing with diagnostic practice and assessment of sickness certificates related to patients with subjective health complaints. The GPs identified some specific strategies that they claimed to apply when dealing with the question of sick leave for patients with subjective health complaints. The first step would be to build an alliance with the patient by complying with the wish for sick leave, and at the same time searching for information to acquire the patient's perspective. This position would become the basis for the main goal: motivating the patient for a rapid return to work by pointing out the positive effects of staying at work, making legal and moral arguments, and warning against long-term sick leave. Additional solutions might also be applied, such as involving other stakeholders in this process to provide alternatives to sick leave. GPs seem to have a conscious approach to negotiations of sickness certification, as they report applying specific strategies to limit the duration of sick leave due to subjective health complaints. This give-and-take way of handling sick-leave negotiations has been suggested by others to enhance return to work, and should be further encouraged. However, specific effectiveness of this strategy is yet to be proven, and further investigation into the actual dealings between doctor and patients in these complex encounters is needed.

  14. Health-related behaviours and sickness absence from work. (United States)

    Laaksonen, M; Piha, K; Martikainen, P; Rahkonen, O; Lahelma, E


    To compare associations of health-related behaviours with self-certified and medically confirmed sickness absence, and to examine whether these associations can be explained by psychosocial and physical working conditions and occupational social class. The study included 5470 female and 1464 male employees of the City of Helsinki surveyed in 2000-2002. These data were linked to sickness absence records until the end of 2005, providing a mean follow-up time of 3.9 years. Poisson regression analysis was used to examine associations of smoking, alcohol use, physical activity, dietary habits and relative weight (body mass index) with self-certified (1-3 days) and medically confirmed (> or =4 days) absence spells. Population attributable fractions (PAFs) were calculated to quantify the sickness absence burden related to the behaviours. Smoking and high relative weight were most strongly associated with sickness absence, while the associations of other studied health-related behaviours were weaker. The associations were stronger for medically confirmed sickness absence spells for which heavy smoking and obesity more than doubled the risk of sickness absence in men and nearly doubled it in women. Adjusting for psychosocial working conditions had little or no effect on the associations. Physical working conditions and social class somewhat attenuated the associations, especially for smoking and relative weight. In self-certified sickness absence the PAF for smoking (16.4 in men, 10.3 in women) was largest, while in medically confirmed absence relative weight had the largest PAF (23.5 in men, 15.0 in women). Health-related behaviours, smoking and high relative weight in particular, were associated with subsequent sickness absence independently of psychosocial and physical working conditions and social class. Decreasing smoking and relative weight is likely to provide important gains in work ability and reduce sickness absence.

  15. Continuous decompression of unicameral bone cyst with cannulated screws: a comparative study. (United States)

    Brecelj, Janez; Suhodolcan, Lovro


    We determined the role of mechanical decompression in the resolution of unicameral bone cyst. A total of 69 children with unicameral bone cysts were treated either by (i) open curettage and bone grafting, (ii) steroid injection or (iii) cannulated screw insertion. During a mean follow-up of 69 months (range, 12-58), the cysts were evaluated by radiological criteria. The healing rates in the three groups were 25, 12 and 29% after the first treatment, and a further 50, 19 and 65% after the second. The study has demonstrated the advantages of the decompression technique for unicameral bone cysts over other treatment modalities studied.

  16. Arthroscopic Resection of The Distal Clavicle With Concomitant Subacromial Decompression: A Case Series

    Directory of Open Access Journals (Sweden)

    HZ Chan


    Full Text Available Shoulder impingement syndrome and acromioclavicular joint osteoarthritis often occur simultaneously and easily missed. Kay et al. reported excellent results with combined arthroscopic subacromial decompression and resection of the distal end of the clavicle in patients with both disorders. Arthroscopic treatment of these disorders produces more favourable results than open procedures. We report two patients who were not responding to conservative management and were treated with direct arthroscopic distal clavicle excision and subacromial decompression in single setting. Both patients gained good postoperative outcome in terms of pain score, function and strength improvement assessed objectively with visual analogue score (VAS and University of California Los Angeles Score (UCLA.

  17. [Assistance and care of the sick in early Christianity]. (United States)

    Maritano, Mario


    Christianity presents a new vision of man (personalistic anthropology) and refers to the example and words of Jesus, highlighting the inseparable relationship between the love of God and the love of man. The article describes the assistance and care of the sick in the East and West in the early Christian centuries; the 'places of care'- nosokomia for the sicks, gerontokomia for the olders, brephotropia for abandoned children, orphanage structures; the managers of hospitals, ecclesistical dignitaries, lay personnel, monks, operators and employees. Christianity gave dignity to the sick and opportunity to serve humanity to the healthy.

  18. Pharmacological and neurophysiological aspects of space/motion sickness (United States)

    Lucot, James B.; Crampton, George H.


    A motorized motion testing device modeled after a Ferris wheel was constructed to perform motion sickness tests on cats. Details of the testing are presented, and some of the topics covered include the following: xylazine-induced emesis; analysis of the constituents of the cerebrospinal fluid (CSF) during motion sickness; evaluation of serotonin-1A (5-HT sub 1A) agonists; other 5HT receptors; antimuscarinic mechanisms; and antihistaminergic mechanisms. The ability of the following drugs to reduce motion sickness in the cats was examined: amphetamines, adenosinergic drugs, opioid antagonists, peptides, cannabinoids, cognitive enhancers (nootropics), dextromethorphan/sigma ligands, scopolamine, and diphenhydramine.

  19. Psychosocial work conditions associated with sickness absence among hospital employees

    DEFF Research Database (Denmark)

    Suadicani, P; Olesen, K; Bonde, J P


    's salary database. RESULTS: A total of 1809 hospital employees took part with a response rate of 65%. The mean age was 43 (range: 20-69) and 75% were female. Totally, 363 study participants (20%) had at least 14 days sickness absence (defined as high absence) during the preceding year. Associations between...... essential covariates of sickness absence. METHODS: A cross-sectional questionnaire study of hospital employees which sought information on elements of the psychosocial work environment, general health status, life style, age, gender and profession. Data on sickness absence were obtained from the employer...

  20. Managerial leadership is associated with self-reported sickness absence and sickness presenteeism among Swedish men and women. (United States)

    Nyberg, Anna; Westerlund, Hugo; Magnusson Hanson, Linda L; Theorell, Töres


    The objective of this study was to investigate the relationship between managerial leadership and self-reported sickness absence/presenteeism among Swedish men and women. Five thousand one hundred and forty-one Swedish employees, 56% of the participants in a nationally representative sample of the Swedish working population, were included in this cross-sectional questionnaire study. The leadership dimensions measured were five subscales of a standardized leadership questionnaire (Global Leadership and Organizational Behaviour Effectiveness Programme): Integrity, Team integration, Inspirational leadership, Autocratic leadership, and Self-centred leadership. Multiple logistic regression analyses were conducted, adjusting for factors in private life, employment category, labour-market sector, working conditions, self-reported general health, and satisfaction with life in general. Inspirational leadership was associated with a lower rate of short spells of sickness absence (women. Autocratic leadership was related to a greater amount of total sick days taken by men. Sometimes showing integrity was associated with higher rate of sickness absence >1 week among men, and seldom showing integrity was associated with more sickness presenteeism among women. Managers performing Team integration were sometimes associated with women taking fewer short (1 week) spells of sickness absence. Adjustment for self-reported general health did not alter these associations for men, but did so to some extent for women. Managerial leadership was found to be relevant for the understanding of sickness absence in the Swedish working population. There were distinctive gender differences.

  1. Undetected common mental disorders in long-term sickness absence

    DEFF Research Database (Denmark)

    Søgaard, Hans Jørgen


    Background. Undetected Common Mental Disorders (CMDs) amongst people on sick leave complicate rehabilitation and return to work because appropriate treatments are not initiated. Aims. The aim of this study is to estimate (1) the frequencies of CMD, (2) the predictors of undetected CMD, and (3...... individuals registered on LSA who were sick-listed without a psychiatric sick leave diagnosis. In this respect, Phase 1 included 831 individuals, who were screened for mental disorders. In Phase 2, following the screening of Phase 1, 227 individuals were thoroughly examined by a psychiatrist applying Present...... State Examination. The analyses of the study were carried out based on the 227 individuals from Phase 2 and, subsequently, weighted to be representative of the 831 individuals in Phase 1. Results. The frequencies of undetected mental disorders among all sick-listed individuals were for any psychiatric...

  2. Effects of Autonomic Conditioning on Motion Sickness Tolerance (United States)

    Cowings, P. S.; Toscano, W. B.


    This paper presents case-studies of 9 shuttle crewmembers (prime and alternates) and one U.S. Navy F-18 pilot, as they participated in all preflight training and testing activities in support of a life sciences flight experiment aboard Spacelab-J, and Spacelab-3. The primary objective of the flight experiment was to determine if Autogenic-feedback training (AFT), a physiological self-regulation training technique would be an effective treatment for motion sickness and space motion sickness in these crewmembers. Additional objectives of this study involved the examining human Physiological- responses to motion sickness on Earth and in space, as well as developing predictive criteria for susceptibility to space motion sickness based on ground-based data. Comparisons of these crewmembers are made to a larger set of subjects from previous experiments (treatment and test-only controls subjects). This paper describes all preflight methods, results and proposed changes for future tests.

  3. Job demands, job resources, and behavior in times of sickness

    DEFF Research Database (Denmark)

    Schneider, Daniel; Winter, Vera; Schreyögg, Jonas


    BACKGROUND: The concept of presenteeism, that is, employees coming to work despite being sick, has recently received more attention in the literature. Presenteeism not only threatens employees' health but also substantially drains productivity and drives considerable costs. When they are sick......, employees have the choice of whether to go to work or to stay at home. Therefore, determinants of (sickness) absenteeism and presenteeism should be examined simultaneously. Nursing homes are faced with a particularly high prevalence of both absenteeism and presenteeism and are therefore a relevant object...... of investigation. PURPOSE: The aim of our study is to analyze the effect of job demands and job resources on absenteeism, presenteeism, and the tendency to choose one behavior (being absent or being present in times of sickness) rather than the other over the last 12 months. To do so, we identify the determinants...

  4. Braid My Hair - Randy Owen sings out for sick children (United States)

    ... Issue Past Issues Braid My Hair - Randy Owen sings out for sick children Past Issues / Spring 2008 ... to it. Former Alabama lead singer Randy Owen sings his new song, "Braid My Hair." Photo courtesy ...

  5. Gut Feelings About Gastritis: When Your Stomach's Sick (United States)

    ... November 2012 Print this issue Gut Feelings About Gastritis When Your Stomach’s Sick Send us your comments ... protective response to injury or infection. is called gastritis, and it can cause long-term problems. Some ...

  6. Sickness absence, moral hazard, and the business cycle. (United States)

    Pichler, Stefan


    The procyclical nature of sickness absence has been documented by many scholars in literature. So far, explanations have been based on labor force composition and reduced moral hazard caused by fear of job loss during recessions. In this paper, we propose and test a third mechanism caused by reduced moral hazard during booms and infections. We suggest that the workload is higher during economic booms and thus employees have to go to work despite being sick. In a theoretical model focusing on infectious diseases, we show that this will provoke infections of coworkers leading to overall higher sickness absence during economic upturns. Using state-level aggregated data from 112 German public health insurance funds (out of 145 in total), we find that sickness absence due to infectious diseases shows the largest procyclical pattern, as predicted by our theoretical model. Copyright © 2014 John Wiley & Sons, Ltd.

  7. Identifying risk factors that contribute to acute mountain sickness

    African Journals Online (AJOL)

    Acute mountain sickness (AMS) is an ever-increasing burden on the health sector. With reported incidences .... schedule to reduce the likelihood of AMS. The data ... of Health and. Multidisciplinary Board on Exercise to identify individuals who.

  8. Explanation of nurse standard of external exposure acute radiation sickness

    International Nuclear Information System (INIS)

    Lu Xiuling; Jiang Enhai; Sun Feifei; Zhang Bin; Wang Xiaoguang; Wang Guilin


    National occupational health standard-Nurse Standard of External Exposure Acute Radiation Sickness has been approved and issued by the Ministry of Health. Based on the extensive research of literature, collection of the previous nuclear and radiation accidents excessive exposed personnel data and specific situations in China, this standard was enacted according to the current national laws, regulations, and the opinions of peer experts. It is mainly used for care of patients with acute radiation sickness, and also has directive significance for care of patients with iatrogenic acute radiation sickness which due to the hematopoietic stem cell transplantation pretreatment. To correctly carry out this standard and to reasonably implement nursing measures for patients with acute radiation sickness, the contents of this standard were interpreted in this article. (authors)

  9. [Teacher sick leave: Prevalence, duration, reasons and covariates]. (United States)

    Vercambre-Jacquot, M-N; Gilbert, F; Billaudeau, N


    Absences from work have considerable social and economic impact. In the education sector, the phenomenon is particularly worrying since teacher sick leave has an impact on the overall performance of the education system. Yet, available data are scarce. In April-June 2013, 2653 teachers responded to a population-based postal survey on their quality of life (enquête Qualité de vie des enseignants, MGEN Foundation/Ministry of education, response rate 53 %). Besides questions on work environment and health, teachers were asked to describe their eventual sick leave(s) since the beginning of the school year: duration, type and medical reasons. Self-reported information was reinforced by administrative data from ministerial databases and weighted to be extrapolated to all French teachers. Tobit models adjusted for individual factors of a private nature were used to investigate different occupational risk factors of teacher sick leave, taking into account both the estimated effect on the probability of sick leave and the length of it. More than one in three teachers (36 %) reported having had at least one day of sick leave since the beginning of the school year. Respiratory/ENT diseases were the leading reason for sick leave (37 %). However, and because sick leave duration depended on the underlying health problem, such diseases came in third place among justifications of sick leave days (14 %), far behind musculoskeletal problems (27 %) and neurological and psychological disorders (25 %). Tobit models suggested that some occupational factors significantly associated with the risk of sick leave may represent promising preventive targets, including high psychological demand, workplace violence and unfavorable socio-environmental context. Our study provides objective evidence about the issue of sick leave among French teachers, highlighting the usefulness of implementing actions to minimize its weight. To this end, the study findings point-out the importance of

  10. Worried sick? Worker Responses to a Financial Shock


    Bratberg, Espen; Monstad, Karin


    Excessive sickness absence may hurt productivity and put a strain on public finances. One explanation put forward for increasing absence rates is that a tougher labour market represents a health hazard. A competing hypothesis is that loss of job security works as a disciplinary device. We use a financial shock that hit the public sector in Norway in 2007 in some, but not all, municipalities to identify the effect of reduced job security on sickness absence. Public sector workers i...

  11. Focus Group Study Exploring Factors Related to Frequent Sickness Absence.

    Directory of Open Access Journals (Sweden)

    Annette Notenbomer

    Full Text Available Research investigating frequent sickness absence (3 or more episodes per year is scarce and qualitative research from the perspective of frequent absentees themselves is lacking. The aim of the current study is to explore awareness, determinants of and solutions to frequent sickness absence from the perspective of frequent absentees themselves.We performed a qualitative study of 3 focus group discussions involving a total of 15 frequent absentees. Focus group discussions were audiotaped and transcribed verbatim. Results were analyzed with the Graneheim method using the Job Demands Resources (JD-R model as theoretical framework.Many participants were not aware of their frequent sickness absence and the risk of future long-term sickness absence. As determinants, participants mentioned job demands, job resources, home demands, poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Managing these factors and improving communication (skills were regarded as solutions to reduce frequent sickness absence.The JD-R model provided a framework for determinants of and solutions to frequent sickness absence. Additional determinants were poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Frequent sickness absence should be regarded as a signal that something is wrong. Managers, supervisors, and occupational health care providers should advise and support frequent absentees to accommodate job demands, increase both job and personal resources, and improve health rather than express disapproval of frequent sickness absence and apply pressure regarding work attendance.

  12. Systematic review of active workplace interventions to reduce sickness absence


    Odeen, Magnus; Magnussen, Liv Heide; Mæland, Silje; Larun, Lillebeth; Eriksen, Hege Randi; Tveito, Torill Helene


    Background: The workplace is used as a setting for interventions to prevent and reduce sickness absence, regardless of the specific medical conditions and diagnoses. Aims: To give an overview of the general effectiveness of active workplace interventions aimed at preventing and reducing sickness absence. Methods: We systematically searched PubMed, Embase, Psych-info, and ISI web of knowledge on 27 December 2011. Inclusion criteria were (i) participants over 18 years old with ...

  13. Hemifacial spasm : Intraoperative electromyographic monitoring as a guide for microvascular decompression

    NARCIS (Netherlands)

    Mooij, JJA; Mustafa, MK; van Weerden, TW


    OBJECTIVE: Microvascular decompression is the logical and well-accepted treatment of choice for hemifacial spasm (HFS). In experienced hands, good to excellent results can be obtained. However, sometimes the exact site of the vascular compression is unclear. The aim of this study was to analyze

  14. Analysis of direct costs of decompressive craniectomy in victims of traumatic brain injury. (United States)

    Badke, Guilherme Lellis; Araujo, João Luiz Vitorino; Miura, Flávio Key; Guirado, Vinicius Monteiro de Paula; Saade, Nelson; Paiva, Aline Lariessy Campos; Avelar, Tiago Marques; Pedrozo, Charles Alfred Grander; Veiga, José Carlos Esteves


    Decompressive craniectomy is a procedure required in some cases of traumatic brain injury (TBI). This manuscript evaluates the direct costs and outcomes of decompressive craniectomy for TBI in a developing country and describes the epidemiological profile. A retrospective study was performed using a five-year neurosurgical database, taking a sample of patients with TBI who underwent decompressive craniectomy. Several variables were considered and a formula was developed for calculating the total cost. Most patients had multiple brain lesions and the majority (69.0%) developed an infectious complication. The general mortality index was 68.8%. The total cost was R$ 2,116,960.22 (US$ 661,550.06) and the mean patient cost was R$ 66,155.00 (US$ 20,673.44). Decompressive craniectomy for TBI is an expensive procedure that is also associated with high morbidity and mortality. This was the first study performed in a developing country that aimed to evaluate the direct costs. Prevention measures should be a priority.

  15. Influence of Lumbar Lordosis on the Outcome of Decompression Surgery for Lumbar Canal Stenosis. (United States)

    Chang, Han Soo


    Although sagittal spinal balance plays an important role in spinal deformity surgery, its role in decompression surgery for lumbar canal stenosis is not well understood. To investigate the hypothesis that sagittal spinal balance also plays a role in decompression surgery for lumbar canal stenosis, a prospective cohort study analyzing the correlation between preoperative lumbar lordosis and outcome was performed. A cohort of 85 consecutive patients who underwent decompression for lumbar canal stenosis during the period 2007-2011 was analyzed. Standing lumbar x-rays and 36-item short form health survey questionnaires were obtained before and up to 2 years after surgery. Correlations between lumbar lordosis and 2 parameters of the 36-item short form health survey (average physical score and bodily pain score) were statistically analyzed using linear mixed effects models. There was a significant correlation between preoperative lumbar lordosis and the 2 outcome parameters at postoperative, 6-month, 1-year, and 2-year time points. A 10° increase of lumbar lordosis was associated with a 5-point improvement in average physical scores. This correlation was not present in preoperative scores. This study showed that preoperative lumbar lordosis significantly influences the outcome of decompression surgery on lumbar canal stenosis. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Treatment of decompression illness with heliox: the best of both worlds?

    NARCIS (Netherlands)

    van Hulst, Robert A.


    There are many ways to treat decompression illness (DCI) at increased pressure. In the last 20 years much has been published on the use of oxygen and helium/oxygen mixtures at different depths. The type of information ranges from impressive work on animals, case reports, small series of case reports

  17. Women's experiences of daily life after anterior cervical decompression and fusion surgery: A qualitative interview study. (United States)

    Hermansen, Anna; Peolsson, Anneli; Kammerlind, Ann-Sofi; Hjelm, Katarina


    To explore and describe women's experiences of daily life after anterior cervical decompression and fusion surgery. Qualitative explorative design. Fourteen women aged 39-62 years (median 52 years) were included 1.5-3 years after anterior cervical decompression and fusion for cervical disc disease. Individual semi-structured interviews were analysed by qualitative content analysis with an inductive approach. The women described their experiences of daily life in 5 different ways: being recovered to various extents; impact of remaining symptoms on thoughts and feelings; making daily life work; receiving support from social and occupational networks; and physical and behavioural changes due to interventions and encounters with healthcare professionals. This interview study provides insight into women's daily life after anterior cervical decompression and fusion. Whilst the subjects improved after surgery, they also experienced remaining symptoms and limitations in daily life. A variety of mostly active coping strategies were used to manage daily life. Social support from family, friends, occupational networks and healthcare professionals positively influenced daily life. These findings provide knowledge about aspects of daily life that should be considered in individualized postoperative care and rehabilitation in an attempt to provide better outcomes in women after anterior cervical decompression and fusion.

  18. Impact of timing of cranioplasty on hydrocephalus after decompressive hemicraniectomy in malignant middle cerebral artery infarction. (United States)

    Finger, Tobias; Prinz, Vincent; Schreck, Evelyn; Pinczolits, Alexandra; Bayerl, Simon; Liman, Thomas; Woitzik, Johannes; Vajkoczy, Peter


    Patients with malignant middle cerebral artery infarction frequently develop hydrocephalus after decompressive hemicraniectomy. Hydrocephalus itself and known shunt related complications after ventriculo-peritoneal shunt implantation may negatively impact patientś outcome. Here, we aimed to identify factors associated with the development of hydrocephalus after decompressive hemicraniectomy in malignant middle cerebral artery infarction. A total of 99 consecutive patients with the diagnosis of large hemispheric infarctions and the indication for decompressive hemicraniectomy were included. We retrospectively evaluated patient characteristics (gender, age and selected preoperative risk factors), stroke characteristics (side, stroke volume and existing mass effect) and surgical characteristics (size of the bone flap, initial complication rate, time to cranioplasty, complication rate following cranioplasty, type of implant, number of revision surgeries and mortality). Frequency of hydrocephalus development was 10% in our cohort. Patients who developed a hydrocephalus had an earlier time point of bone flap reimplantation compared to the control group (no hydrocephalus=164±104days, hydrocephalus=108±52days, phydrocephalus with a trend towards significance (p=0.08). Communicating hydrocephalus is frequent in patients with malignant middle cerebral artery infarction after decompressive hemicraniectomy. A later time point of cranioplasty might lead to a lower incidence of required shunting procedures in general as we could show in our patient cohort. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Assessment of two methods of gastric decompression for the initial management of gastric dilatation-volvulus. (United States)

    Goodrich, Z J; Powell, L L; Hulting, K J


    To assess gastric trocarization and orogastric tubing as a means of gastric decompression for the initial management of gastric dilatation-volvulus. Retrospective review of 116 gastric dilatation-volvulus cases from June 2001 to October 2009. Decompression was performed via orogastric tubing in 31 dogs, gastric trocarization in 39 dogs and a combination of both in 46 dogs. Tubing was successful in 59 (75·5%) dogs and unsuccessful in 18 (23·4%) dogs. Trocarization was successful in 73 (86%) dogs and unsuccessful in 12 (14%) dogs. No evidence of gastric perforation was noted at surgery in dogs undergoing either technique. One dog that underwent trocarization had a splenic laceration identified at surgery that did not require treatment. Oesophageal rupture or aspiration pneumonia was not identified in any dog during hospitalization. No statistical difference was found between the method of gastric decompression and gastric compromise requiring surgical intervention or survival to discharge. Orogastric tubing and gastric trocarization are associated with low complication and high success rates. Either technique is an acceptable method for gastric decompression in dogs with gastric dilatation-volvulus. © 2013 British Small Animal Veterinary Association.

  20. Exogenous application of platelet-leukocyte gel during open subacromial decompression contributes to improved patient outcome

    NARCIS (Netherlands)

    Everts, P. A.; Devilee, R. J. J.; Mahoney, C. Brown; van Erp, A.; Oosterbos, C. J. M.; Stellenboom, M.; Knape, J. T. A.; van Zundert, A.


    Background: Platelet-leukocyte gel (PLG) is being used during various surgical procedures in an attempt to enhance the healing process. We studied the effects of PLG on postoperative recovery of patients undergoing open subacromial decompression (OSD). Methods: PLG was produced from

  1. Rectus extraocular muscle paths and decompression surgery for Graves orbitopathy: mechanism of motility disturbances

    NARCIS (Netherlands)

    Abràmoff, Michael D.; Kalmann, Rachel; de Graaf, Mieke E. L.; Stilma, Jan S.; Mourits, Maarten P.


    PURPOSE: To study possible causes of motility disturbances that may result from orbital decompression surgery in patients with Graves orbitopathy and especially the role of rectus extraocular muscle paths. METHODS: Sixteen patients with Graves orbitopathy were studied before and 3 to 6 months after

  2. Economic evaluation of decompressive craniectomy versus barbiturate coma for refractory intracranial hypertension following traumatic brain injury. (United States)

    Alali, Aziz S; Naimark, David M J; Wilson, Jefferson R; Fowler, Robert A; Scales, Damon C; Golan, Eyal; Mainprize, Todd G; Ray, Joel G; Nathens, Avery B


    Decompressive craniectomy and barbiturate coma are often used as second-tier strategies when intracranial hypertension following severe traumatic brain injury is refractory to first-line treatments. Uncertainty surrounds the decision to choose either treatment option. We investigated which strategy is more economically attractive in this context. We performed a cost-utility analysis. A Markov Monte Carlo microsimulation model with a life-long time horizon was created to compare quality-adjusted survival and cost of the two treatment strategies, from the perspective of healthcare payer. Model parameters were estimated from the literature. Two-dimensional simulation was used to incorporate parameter uncertainty into the model. Value of information analysis was conducted to identify major drivers of decision uncertainty and focus future research. Trauma centers in the United States. Base case was a population of patients (mean age = 25 yr) who developed refractory intracranial hypertension following traumatic brain injury. We compared two treatment strategies: decompressive craniectomy and barbiturate coma. Decompressive craniectomy was associated with an average gain of 1.5 quality-adjusted life years relative to barbiturate coma, with an incremental cost-effectiveness ratio of $9,565/quality-adjusted life year gained. Decompressive craniectomy resulted in a greater quality-adjusted life expectancy 86% of the time and was more cost-effective than barbiturate coma in 78% of cases if our willingness-to-pay threshold is $50,000/quality-adjusted life year and 82% of cases at a threshold of $100,000/quality-adjusted life year. At older age, decompressive craniectomy continued to increase survival but at higher cost (incremental cost-effectiveness ratio = $197,906/quality-adjusted life year at mean age = 85 yr). Based on available evidence, decompressive craniectomy for the treatment of refractory intracranial hypertension following traumatic brain injury provides better

  3. The Proceedings of the Hypobaric Decompression Sickness Workshop Held in Armstrong Laboratory, Brooks AFB, Texas on 16-18 October 1990. (United States)


    absence of Air in the Bloud iuyces. and soft parts of the Body. may by their Vast number. and their conspiring distension , variously streighten in...and vitiating the figure of others. disturb or hinder the due circulation of the Bloud? Not to mention the pains that such distensions may cause in...Effects of Altitude on Aviators. Aviation, 2, 145-147 (1917). 10. Barcroft, J.; C.G. Douglas; L.P. Kendall and R. Margaria. Muscular Exercise at Low

  4. Go to work or report sick? A focus group study on decisions of sickness presence among offshore catering section workers. (United States)

    Krohne, Kariann; Magnussen, Liv Heide


    To identify and explore the factors promoting sickness presenteeism among offshore catering section workers. Twenty men and women, working in the offshore catering section onboard three offshore oil and gas production platforms on the Norwegian Continental Shelf, participated in three focus groups. Data from the focus groups were analysed according to a phenomenological approach, and supported by theories on presenteeism. The results show that the decision to attend work despite illness, first and foremost, was based on the severity of the health complaint. Other factors identified were; the individual's location once the health complaint occurred, job satisfaction, the norms of the team, and experiences of how company policies on sickness absenteeism were implemented by the catering section leaders. Offshore working conditions may promote sickness presenteeism. The factors promoting sickness presenteeism onboard the platforms reflected experiences of a healthy work environment.

  5. Go to work or report sick? A focus group study on decisions of sickness presence among offshore catering section workers

    Directory of Open Access Journals (Sweden)

    Krohne Kariann


    Full Text Available Abstract Background To identify and explore the factors promoting sickness presenteeism among offshore catering section workers. Methods Twenty men and women, working in the offshore catering section onboard three offshore oil and gas production platforms on the Norwegian Continental Shelf, participated in three focus groups. Data from the focus groups were analysed according to a phenomenological approach, and supported by theories on presenteeism. Results The results show that the decision to attend work despite illness, first and foremost, was based on the severity of the health complaint. Other factors identified were; the individual's location once the health complaint occurred, job satisfaction, the norms of the team, and experiences of how company policies on sickness absenteeism were implemented by the catering section leaders. Conclusions Offshore working conditions may promote sickness presenteeism. The factors promoting sickness presenteeism onboard the platforms reflected experiences of a healthy work environment.

  6. A Kink that Makes you Sick: the Effect of Sick Pay on Absence in a Social Insurance System


    Petri Bockerman; Ohto Kanninen; Ilpo Suoniemi


    We examine the effect of the replacement rule of a social insurance system on sickness absence. The elasticity of absence with respect to the benefit level is a critical parameter in defining the optimal sickness insurance scheme. A pre-determined, piecewise linear policy rule in which the replacement rate is determined by past earnings allows identification of the causal effect using a regression kink design. Using a large administrative dataset, we find a substantial and robust behavioral r...

  7. Does Early Decompressive Craniectomy Improve Outcome? Experience from an Active UK Recruiter Centre

    Directory of Open Access Journals (Sweden)

    E. García Vicente


    Full Text Available Introduction. The results of the recent DECRA study suggest that although craniectomy decreases ICP and ICU length of stay, it is also associated with worst outcomes. Our experience, illustrated by these two striking cases, supports that early decompressive craniectomy may significantly improve the outcome in selected patients. Case Reports. The first patient, a 20-year-old man who suffered severe brain contusion and subarachnoid haemorrhage after a fall downstairs, with refractory ICP of 35 mmHg, despite maximal medical therapy, eventually underwent decompressive craniectomy. After 18 days in intensive care, he was discharged for rehabilitation. The second patient, a 23-year-old man was found at the scene of a road accident with a GCS of 3 and fixed, dilated pupils who underwent extensive unilateral decompressive craniectomy for refractory intracranial hypertension. After three weeks of cooling, paralysis, and neuroprotection, he eventually left ICU for rehabilitation. Outcomes. Four months after leaving ICU, the first patient abseiled 40 m down the main building of St. Mary’s Hospital to raise money for the Trauma Unit. He has returned to part-time work. The second patient, was decannulated less than a month later and made a full cognitive recovery. A year later, with a titanium skull prosthesis, he is back to part-time work and to playing football. Conclusions. Despite the conclusions of the DECRA study, our experience of the use of early decompressive craniectomy has been associated with outstanding outcomes. We are currently actively recruiting patients into the RESCUEicp trial and have high hopes that it will clarify the role of the decompressive craniectomy in traumatic brain injury and whether it effectively improves outcomes.

  8. Surgical outcome after decompressive craniectomy in patients with extensive cerebral infarction

    International Nuclear Information System (INIS)

    Otani, Naoki; Takasato, Yoshio; Masaoka, Hiroyuki


    Extensive cerebral hemispheric infarction is a devastating condition leading to early death in nearly 80% of cases due to the rapid rise of intracranial pressure in spite of maximum medical treatment for brain edema and swelling. Recently, decompressive craniectomy has been reevaluated to prevent the brain herniation caused by extensive hemispheric cerebral infarction. We studied the surgical results after decompressive craniectomy for extensive cerebral infarction. Between December 1997 and August 2006, 13 consecutive patients (7 males and 6 females aged from 39 to 73 with a mean age of 59 years) with massive cerebral infarction of internal carotid (IC) (11 patients) and middle cerebral artery (MCA) (2 patients) territory were treated with decompressive craniectomy and dural plasty. Five patients had a left-sided stroke with severe aphasia. The cardioembolic source of stroke was seen in 5 patients. Surgery was performed at the point of neurological deterioration, anisocoria, and effacement of perimesencephalic cistern on CT findings. The mean time between stroke onset and surgery was 39.8 hr and ranged from 13 to 102 hr. Glasgow outcome scale (GOS) on discharge was moderately disabled (MD) 1, severe disabled (SD) 5, vegetative state (VS) 1, and dead (D) 3 (mortality rate 30.8%). Severe pneumoniae were the causes of death. All survivors underwent cranioplasty and were transferred with the aim of rehabilitation. In this study, we showed that the decompressive craniectomy reduced mortality after extensive cerebral infarction. However, the functional outcome and level of independence are poor. It seems that the early decompressive craniectomy should be aggressively performed for extensive cerebral infarction before neurological deterioration such as worsening of consciousness disturbance or pupil abnormalities. Further investigations will be needed to clarify the surgical indications, timing, and functional outcomes. (author)

  9. Does decompression of odontogenic cysts and cystlike lesions change the histologic diagnosis? (United States)

    Schlieve, Thomas; Miloro, Michael; Kolokythas, Antonia


    The purpose of this study was to report the histopathologic findings after postdecompression definitive treatment of odontogenic cystlike lesions and determine whether the diagnosis was consistent with the pretreatment diagnosis, thereby answering the clinical question: does decompression change the histologic diagnosis? The authors implemented a retrospective cohort study from a sample of patients diagnosed with a benign odontogenic cystlike lesion and who underwent decompression followed by definitive surgery as part of their treatment. The predictor variable was treatment by decompression and the dependent variable was change in histologic diagnosis. Age, gender, and lesion location were included as variables. The χ(2) test was used for statistical analysis of the categorical data and P values less than .05 were considered statistically significant. Twenty-five cysts and cystlike lesions in 25 patients were treated with decompression followed by enucleation and curettage. The mean age was 34 years (range, 13 to 80 yr) and 56% (14) were male patients. Lesions were located in the mandible in 76% (19 of 25) of patients. Postdecompression histologic examination at the time of definitive surgical treatment was consistent with the preoperative biopsy diagnosis in 91% (10 of 11) of keratocystic odontogenic tumors, 67% (2 of 3) of glandular odontogenic cysts, 75% (3 of 4) of dentigerous cysts, and 100% (7 of 7) of cystic ameloblastomas. The histologic diagnosis at time of definitive treatment by enucleation and curettage is consistent with the predecompression diagnosis. Therefore, all lesions should be definitively treated after decompression based on the initial lesion diagnosis, with all patients placed on appropriate follow-up protocols. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. All rights reserved.

  10. ORACLE Stroke Study: Opinion Regarding Acceptable Outcome Following Decompressive Hemicraniectomy for Ischemic Stroke. (United States)

    Honeybul, Stephen; Ho, Kwok M; Blacker, David W


    There continues to be considerable interest in the use of decompressive hemicraniectomy in the management of malignant cerebral artery infarction; however, concerns remain about long-term outcome. To assess opinion on consent and acceptable outcome among a wide range of healthcare workers. Seven hundred seventy-three healthcare workers at the 2 major public neurosurgical centers in Western Australia participated. Participants were asked to record their opinion on consent and acceptable outcome based on the modified Rankin Score (mRS). The evidence for clinical efficacy of the procedure was presented, and participants were then asked to reconsider their initial responses. Of the 773 participants included in the study, 407 (52.7%) initially felt that they would provide consent for a decompressive craniectomy as a lifesaving procedure, but only a minority of them considered an mRS score of 4 or 5 an acceptable outcome (for mRS score ≤4, n = 67, 8.7%; for mRS score = 4, n = 57, 7.4%). After the introduction of the concept of the disability paradox and the evidence for the clinical efficacy of decompressive craniectomy, more participants were unwilling to accept decompressive craniectomy (18.1% vs 37.8%), but at the same time, more were willing to accept an mRS score ≤4 as an acceptable outcome (for mRS score ≤4, n = 92, 11.9%; for mRS score = 4, n = 79, 10.2%). Most participants felt survival with dependency to be unacceptable. However, many would be willing to provide consent for surgery in the hopes that they may survive with some degree of independence. DESTINY, Decompressive Surgery for the Treatment of Malignant Infarction of the Middle Cerebral ArterymRS, modified Rankin Scale.

  11. Facet Effusion without Radiographic Instability Has No Effect on the Outcome of Minimally Invasive Decompression Surgery. (United States)

    Tamai, Koji; Kato, Minori; Konishi, Sadahiko; Matsumura, Akira; Hayashi, Kazunori; Nakamura, Hiroaki


    Retrospective cohort study. Lumbar segmental instability is a key factor determining whether decompression alone or decompression and fusion surgery is required to treat lumbar spinal stenosis (LSS). Some recent reports have suggested that facet joint effusion is correlated with spinal segmental instability. The aim of this study is to report the effect of facet effusion without radiographic segmental instability on the outcome of less-invasive decompression surgery for LSS. Seventy-nine patients with LSS (32 women, mean age: 69.1 ± 9.1 years) who had no segmental instability on dynamic radiographs before undergoing L4-L5 microsurgical decompression and who were followed for at least 2 years postoperatively were analyzed. They were divided into three groups on the basis of the existence and size of L4-L5 facet effusion using preoperative magnetic resonance imaging: grade 0 had no effusion ( n  = 31), grade 1 had measurable effusion ( n  = 35), and grade 2 had large effusion ( n  = 13). Japanese Orthopedics Association (JOA) score, visual analog scale (VAS), and the Short-Form (SF)-36 scores were recorded preoperatively and 12 and 24 months postoperatively. JOA score; VAS of low back pain, leg pain, and numbness; and SF-36 (physical component summary and mental component summary) scores did not differ significantly between the three groups in every terms ( p  = 0.921, 0.996, 0.950, 0.693, 0.374, 0.304, and 0.624, respectively, at final follow-up). In the absence of radiographic instability, facet joint effusion has no effect on the outcome of less-invasive decompression surgery.

  12. Mortality Rates After Emergent Posterior Fossa Decompression for Ischemic or Hemorrhagic Stroke in Older Patients. (United States)

    Puffer, Ross C; Graffeo, Christopher; Rabinstein, Alejandro; Van Gompel, Jamie J


    Cerebellar stroke causes major morbidity in the aging population. Guidelines from the American Stroke Association recommend emergent decompression in patients who have brainstem compression, hydrocephalus, or clinical deterioration. The objective of this study was to determine 30-day and 1-year mortality rates in patients >60 years old undergoing emergent posterior fossa decompression. Surgical records identified all patients >60 years old who underwent emergent posterior fossa decompression. Mortality rates were calculated at 30 days and 1 year postoperatively, and these rates were compared with patient and procedure characteristics. During 2000-2014, 34 emergent posterior fossa decompressions were performed in patients >60 years old. Mortality rates at 30 days were 0%, 33%, and 25% for age deciles 60-69 years, 70-79 years, and ≥80 years. Increasing age (alive at 30 days 75.2 years ± 1.7 vs. deceased 81.1 years ± 1.7, P = 0.01) and smaller craniectomy dimensions were associated with 30-day mortality. Mortality rates at 1 year were 0%, 50%, and 67% for age deciles 60-69 years, 70-79 years, and ≥80 years. Increasing age was significantly associated with mortality at 1 year (alive at 1 year 72.3 years ± 2.0 vs. deceased 81.1 years ± 1.2, P mortality. Age was independent of admission Glasgow Coma Scale score as a predictor of mortality at 30 days, 90 days, and 1 year postoperatively. Increasing age and smaller craniectomy size were significantly associated with mortality in patients undergoing emergent posterior fossa decompression. Among patients ≥80 years old, one-quarter were dead within 1 month of the operation, and more than two-thirds were dead within 1 year. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Do work-place initiated measures reduce sickness absence? Preventive measures and sickness absence among older workers in Norway. (United States)

    Midtsundstad, Tove I; Nielsen, Roy A


    The article examines whether preventive measures and work adjustments at the establishment level affects sickness absence among workers aged 50 years and older. We combine survey data from a representative sample of 713 Norwegian companies, mapping the prevalence of preventive health measures in the work place in 2005, with register data on sickness absence and demographic variables for workers aged 50 years or older in 2001 and 2007. By means of a difference-in-differences approach, we compare changes and differences in the likelihood of sickness absence among the sample group, with and without the various measures/ instruments in 2005 respectively. In general, work-place preventive measures at the establishment level have not contributed to reducing the probability for sickness absence among workers aged 50 years and older. However, analyses comparing differences between industries find that the work-place measures have had a positive effect on public administration employees. Whether work-place preventive initiatives influence levels of sickness absence seems to be contingent on sector and industry. Therefore, work-place measures may be more effective in the public administration sector where most employees have office jobs compared to sectors such as manufacturing, construction and transportation, where many employees have manual work and more physical demanding jobs. Work-place initiatives thus seem to have less effect on preventing sickness absence in sectors dominated by manual labour.

  14. Part-time sick leave as a treatment method for individuals with musculoskeletal disorders. (United States)

    Andrén, Daniela; Svensson, Mikael


    There is increasing evidence that staying active is an important part of a recovery process for individuals on sick leave due to musculoskeletal disorders (MSDs). It has been suggested that using part-time sick-leave rather than full-time sick leave will enhance the possibility of full recovery to the workforce, and several countries actively favor this policy. The aim of this paper is to examine if it is beneficial for individuals on sick leave due to MSDs to be on part-time sick leave compared to full-time sick leave. A sample of 1,170 employees from the RFV-LS (register) database of the Social Insurance Agency of Sweden is used. The effect of being on part-time sick leave compared to full-time sick leave is estimated for the probability of returning to work with full recovery of lost work capacity. A two-stage recursive bivariate probit model is used to deal with the endogeneity problem. The results indicate that employees assigned to part-time sick leave do recover to full work capacity with a higher probability than those assigned to full-time sick leave. The average treatment effect of part-time sick leave is 25 percentage points. Considering that part-time sick leave may also be less expensive than assigning individuals to full-time sick leave, this would imply efficiency improvements from assigning individuals, when possible, to part-time sick leave.

  15. Severe occupational hand eczema, job stress and cumulative sickness absence. (United States)

    Böhm, D; Stock Gissendanner, S; Finkeldey, F; John, S M; Werfel, T; Diepgen, T L; Breuer, K


    Stress is known to activate or exacerbate dermatoses, but the relationships between chronic stress, job-related stress and sickness absence among occupational hand eczema (OHE) patients are inadequately understood. To see whether chronic stress or burnout symptoms were associated with cumulative sickness absence in patients with OHE and to determine which factors predicted sickness absence in a model including measures of job-related and chronic stress. We investigated correlations of these factors in employed adult inpatients with a history of sickness absence due to OHE in a retrospective cross-sectional explorative study, which assessed chronic stress (Trier Inventory for the Assessment of Chronic Stress), burnout (Shirom Melamed Burnout Measure), clinical symptom severity (Osnabrück Hand Eczema Severity Index), perceived symptom severity, demographic characteristics and cumulative days of sickness absence. The study group consisted of 122 patients. OHE symptoms were not more severe among patients experiencing greater stress and burnout. Women reported higher levels of chronic stress on some measures. Cumulative days of sickness absence correlated with individual dimensions of job-related stress and, in multiple regression analysis, with an overall measure of chronic stress. Chronic stress is an additional factor predicting cumulative sickness absence among severely affected OHE patients. Other relevant factors for this study sample included the 'cognitive weariness' subscale of the Shirom Melamed Burnout Measure and the physical component summary score of the SF-36, a measure of health-related life quality. Prevention and rehabilitation should take job stress into consideration in multidisciplinary treatment strategies for severely affected OHE patients. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email:

  16. Sickness presenteeism in Norway and Sweden

    Directory of Open Access Journals (Sweden)

    Vegard Johansen


    Full Text Available Introduction: Sickness presenteeism (SP refers to the practice of going to work despite illness. This article describes the distribution of SP in Norway and Sweden. It also discusses relations between SP and various work characteristics and personal factors in the two countries. Methods: More than 2500 Norwegian and Swedish workers between 20 and 60 years of age answered a postal questionnaire. The Norwegian and Swedish samples are weighed and representative with regard to both variables of regional background and demography, but the response rate was low. The distribution of SP is measured by frequency (episodes in the previous year and by length (total days of SP in the previous year. This study employed binary and multinomial logistic regression to detect which factors influence the frequency of SP. Results: Fifty-five per cent of the respondents in Norway and Sweden practised SP in the previous year. The frequency of SP episodes is similar in the two countries. Further, respondents with low/medium income, physical work, and managerial responsibilities report SP more often in both countries. Non-western immigrants, the less educated, and those employed by others are overrepresented with SP in Norway. Neither gender nor age had any particular influence. Discussion: In accordance with previous studies, this study among Norwegian and Swedish workers suggests that some SP during a working year may be more common than no SP. Our analyses of determinants of SP present some previously undocumented differences. Divisions between sedentary versus physical work and management versus non-management were important for SP in Norway and Sweden. Moreover, non-western immigrants are overrepresented with SP in Norway, but this pattern does not prevail in Sweden. Some possible causes for non-western immigrants to report more SP are suggested in the article, but we need more research to follow up on the missing correlation between ethnic background and SP in

  17. Does self-efficacy predict return-to-work after sickness absence? A prospective study among 930 employees with sickness absence for three weeks or more

    DEFF Research Database (Denmark)

    Labriola, Merete; Lund, Thomas; Christensen, Karl B


    follows a cohort of 5357 working employees and 106 long-term sickness absent employees in Denmark. They were interviewed in 2000 regarding self-efficacy and various co-variates, and followed for 78 weeks in a national sickness absence register. Cox regression analysis was performed in order to assess...... or with Return-to-Work. CONCLUSION: The results may suggest that lower self-efficacy among employees with sickness absence is a result of the sickness absence itself rather than a precursor of it. This indicates a need to investigate the potential change in self-efficacy in relation to the employee's change......AIM: To compare levels of self-efficacy among the general working population and employees with sickness absence from work, and to examine if general self-efficacy measured before occurrence of sickness absence predicted subsequent onset of sickness absence and Return-to-Work. METHODS: The study...

  18. Pleasant music as a countermeasure against visually induced motion sickness. (United States)

    Keshavarz, Behrang; Hecht, Heiko


    Visually induced motion sickness (VIMS) is a well-known side-effect in virtual environments or simulators. However, effective behavioral countermeasures against VIMS are still sparse. In this study, we tested whether music can reduce the severity of VIMS. Ninety-three volunteers were immersed in an approximately 14-minute-long video taken during a bicycle ride. Participants were randomly assigned to one of four experimental groups, either including relaxing music, neutral music, stressful music, or no music. Sickness scores were collected using the Fast Motion Sickness Scale and the Simulator Sickness Questionnaire. Results showed an overall trend for relaxing music to reduce the severity of VIMS. When factoring in the subjective pleasantness of the music, a significant reduction of VIMS occurred only when the presented music was perceived as pleasant, regardless of the music type. In addition, we found a gender effect with women reporting more sickness than men. We assume that the presentation of pleasant music can be an effective, low-cost, and easy-to-administer method to reduce VIMS. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  19. Sickness absence among health workers in belo horizonte, brazil. (United States)

    Bassi, Iara; Assunção, Ada Ávila; Pimenta, Adriano Marçal; Benavides, Fernando G; Ubalde-Lopez, Monica


    To describe the prevalence of sickness absence and to analyze factors associated with the outcome according to gender in a sample of healthcare workers at the Belo Horizonte Health Department. This study was based on a Belo Horizonte Health Department survey carried out between September 2008 and January 2009. From a randomly selected sample of 2,205 workers, 1,808 agreed to participate. Workers were classified into Health Staff or Health Care. Other explanatory variables were social and demographic data, work characteristics, and personal health. The Poisson regression was applied to analyze factors associated with sickness absence by the prevalence ratio (PR). The overall prevalence of sickness absence was 31.5% (23.8% for men and 34.6% for women). In the final model, we found higher rates of sickness absence in both male and female workers involved in tasks with high psychosocial demands (PR=1.86 men; PR=1.38 women) and in those that reported using medication for treating chronic diseases (PR=1.96 men; PR=1.50 women). Women having a permanent job contract had a higher prevalence of sickness absence than those having a temporary job contract (PR=1.71). Our findings suggest a paradox in how healthcare is organized: good results in terms of its global objective of providing healthcare for citizens contrast with lack of effective measures for protecting healthcare workers.


    Škerjanc, Alenka; Fikfak, Metoda Dodič


    The aim of the study is to investigate the relationship between sickness presence and stressful life events among health care workers. Data were gathered from all health care workers at the University Medical Centre Ljubljana employed there in the period between 1 January 2010 and 31 December 2010. Each employee obtained a questionnaire composed of two standardized international questionnaires. There were 57% of sickness present health care workers among the participants. The sickness present reported to have more diseases of family member than the non-sickness present (OR = 1.5; 95% CI = 1.2-2.0), loan (OR = 1.4; 95% CI = 1.1-1.6), their partner lost job (OR = 1.4; 95% CI = 1.0-1.8), or they changed the place of living (OR = 1.4; 95% CI = 1.0-2.0). The results of the study indicate that stressful life events with economic consequences might have an important influence on sickness presence.

  1. Sensory conflict in motion sickness: An observer theory approach (United States)

    Oman, Charles M.


    Motion sickness is the general term describing a group of common nausea syndromes originally attributed to motion-induced cerebral ischemia, stimulation of abdominal organ afferent, or overstimulation of the vestibular organs of the inner ear. Sea-, car-, and airsicknesses are the most commonly experienced examples. However, the discovery of other variants such as Cinerama-, flight simulator-, spectacle-, and space sickness in which the physical motion of the head and body is normal or absent has led to a succession of sensory conflict theories which offer a more comprehensive etiologic perspective. Implicit in the conflict theory is the hypothesis that neutral and/or humoral signals originate in regions of the brain subversing spatial orientation, and that these signals somehow traverse to other centers mediating sickness symptoms. Unfortunately, the present understanding of the neurophysiological basis of motion sickness is far from complete. No sensory conflict neuron or process has yet been physiologically identified. To what extent can the existing theory be reconciled with current knowledge of the physiology and pharmacology of nausea and vomiting. The stimuli which causes sickness, synthesizes a contemporary Observer Theory view of the Sensory Conflict hypothesis are reviewed, and a revised model for the dynamic coupling between the putative conflict signals and nausea magnitude estimates is presented. The use of quantitative models for sensory conflict offers a possible new approach to improving the design of visual and motion systems for flight simulators and other virtual environment display systems.

  2. Sickness absence at a young age and later sickness absence, disability pension, death, unemployment and income in native Swedes and immigrants (United States)

    Johansson, Bo; Nordqvist, Tobias; Lundberg, Ingvar; Vingård, Eva


    Background: Sickness absence with cash benefits from the sickness insurance gives an opportunity to be relieved from work without losing financial security. There are, however, downsides to taking sickness absence. Periods of sickness absence, even short ones, can increase the risk for future spells of sickness absence and unemployment. The sickness period may in itself have a detrimental effect on health. The aim of the study was to investigate if there is an association between exposure to sickness absence at a young age and later sickness absence, disability pension, death, unemployment and income from work. Methods: Our cohort consisted of all immigrants aged 21–25 years in Sweden in 1993 (N = 38 207) and a control group of native Swedes in the same age group (N = 225 977). We measured exposure to sickness absence in 1993 with a follow-up period of 15 years. We conducted separate analyses for men and women, and for immigrants and native Swedes. Results: Exposure to ≥60 days of sickness absence in 1993 increased the risk of sickness absence [hazard ratio (HR) 1.6–11.4], unemployment (HR 1.1–1.2), disability pension (HR 1.2–5.3) and death (HR 1.2–3.5). The income from work, during the follow-up period, among individuals with spells of sick leave for ≥60 days in 1993 was around two-thirds of that of the working population who did not take sick leave. Conclusions: Individuals on sickness absence had an increased risk for work absence, death and lower future income. PMID:25634955

  3. Early biliary decompression versus conservative treatment in acute biliary pancreatitis (APEC trial): study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Schepers, N.J.; Bakker, O.J.; Besselink, M.G.; Bollen, T.L.; Dijkgraaf, M.G.; Eijck, C.H. van; Fockens, P.; Geenen, E.J. van; Grinsven, J. van; Hallensleben, N.D.; Hansen, B.E.; Santvoort, H.C. van; Timmer, R.; Anten, M.P.; Bolwerk, C.J.; Delft, F. von; Dullemen, H.M. van; Erkelens, G.W.; Hooft, J.E. van; Laheij, R.; Hulst, R.W. van der; Jansen, J.M.; Kubben, F.J.; Kuiken, S.D.; Perk, L.E.; Ridder, R.J. de; Rijk, M.C. de; Romkens, T.E.; Schoon, E.J.; Schwartz, M.P.; Spanier, B.W.; Tan, A.C.; Thijs, W.J.; Venneman, N.G.; Vleggaar, F.P.; Vrie, W. van de; Witteman, B.J.; Gooszen, H.G.; Bruno, M.J.


    BACKGROUND: Acute pancreatitis is mostly caused by gallstones or sludge. Early decompression of the biliary tree by endoscopic retrograde cholangiography (ERC) with sphincterotomy may improve outcome in these patients. Whereas current guidelines recommend early ERC in patients with concomitant

  4. Early biliary decompression versus conservative treatment in acute biliary pancreatitis (APEC trial): Study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    N.J. Schepers (Nicolien); O.J. Bakker (Olaf ); M.G. Besselink (Marc); T.L. Bollen (Thomas); M.G.W. Dijkgraaf (Marcel); C.H.J. van Eijck (Casper); P. Fockens (Paul); E-J.M. Geenen (Erwin-Jan); J. van Grinsven (Janneke); N.D.L. Hallensleben (Nora D.L.); B.E. Hansen (Bettina); H.C. van Santvoort (Hjalmar); R. Timmer (Robin); M.-P.G.F. Anten (Marie-Paule G.F.); C.L. Bolwerk (Clemens); F. van Delft (Foke); H.M. van Dullemen (Hendrik); G.W. Erkelens (G.Willemien); J.E. van Hooft (Jeanin); C. Laheij (Claudia); R.W.M. van der Hulst (René); J.M. Jansen (Jeroen); F.J. Kubben; S.D. Kuiken (Sjoerd D.); L.E. Perk (Lars E.); R. de Ridder (Rogier); M.C.M. Rijk; T.E.H. Römkens; E.J. Schoon (Erik); M.P. Schwartz (Matthijs P.); B.W.M. Spanier (Marcel); A.C. Tan (Adriaan); W.J. Thijs; N.G. Venneman (Niels); F.P. Vleggaar (Frank); W. van de Vrie (Wim); B.J.M. Witteman (Ben); H.G. Gooszen (Hein); M.J. Bruno (Marco)


    textabstractBackground: Acute pancreatitis is mostly caused by gallstones or sludge. Early decompression of the biliary tree by endoscopic retrograde cholangiography (ERC) with sphincterotomy may improve outcome in these patients. Whereas current guidelines recommend early ERC in patients with

  5. Successful Treatment of Early Talar Osteonecrosis by Core Decompression Combined with Intraosseous Stem Cell Injection: A Case Report. (United States)

    Nevalainen, Mika T; Repo, Jussi P; Pesola, Maija; Nyrhinen, Jukka P


    Osteonecrosis of the talus is a fairly rare condition. Many predisposing factors have been identified including previous trauma, use of corticosteroids, alcoholism, and smoking. As a gold standard, magnetic resonance imaging (MRI) is the most sensitive and specific diagnostic examination to detect osteonecrosis. While many treatment options for talar osteonecrosis exist, core decompression is suggested on young patients with good outcome results. More recently, intraosseous stem cell and platelet-rich plasma (PRP) injection has been added to the core decompression procedure. We report a successful treatment of early talar osteonecrosis ARCO I (Association Research Circulation Osseous) by core decompression combined with stem cell and PRP injection. On 3-month and 15-month follow-up, MRI showed complete resolution of the osteonecrotic changes together with clinical improvement. This modified technique is a viable treatment option for early talar osteonecrosis. Nevertheless, future prospects should include a study comparing this combined technique with plain core decompression.

  6. Early biliary decompression versus conservative treatment in acute biliary pancreatitis (APEC trial) : Study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Schepers, Nicolien J.; Bakker, Olaf J.; Besselink, Marc G H; Bollen, Thomas L.; Dijkgraaf, Marcel G W; van Eijck, Casper H J; Fockens, Paul; van Geenen, Erwin J M; van Grinsven, Janneke; Hallensleben, Nora D L; Hansen, Bettina E.; van Santvoort, Hjalmar C.; Timmer, Robin; Anten, Marie Paule G F; Bolwerk, Clemens J M; van Delft, Foke; van Dullemen, Hendrik M.; Erkelens, G. Willemien; van Hooft, Jeanin E.; Laheij, Robert; van der Hulst, René W M; Jansen, Jeroen M.; Kubben, Frank J G M; Kuiken, Sjoerd D.; Perk, Lars E.; de Ridder, Rogier J J; Rijk, Marno C M; Römkens, Tessa E H; Schoon, Erik J.; Schwartz, Matthijs P.; Spanier, B. W Marcel; Tan, Adriaan C I T L; Thijs, Willem J.; Venneman, Niels G.; Vleggaar, Frank P.; van de Vrie, Wim; Witteman, Ben J.; Gooszen, Hein G.; Bruno, Marco J.


    Background: Acute pancreatitis is mostly caused by gallstones or sludge. Early decompression of the biliary tree by endoscopic retrograde cholangiography (ERC) with sphincterotomy may improve outcome in these patients. Whereas current guidelines recommend early ERC in patients with concomitant

  7. Associations between partial sickness benefit and disability pensions: initial findings of a Finnish nationwide register study. (United States)

    Kausto, Johanna; Virta, Lauri; Luukkonen, Ritva; Viikari-Juntura, Eira


    Timely return to work after longterm sickness absence and the increased use of flexible work arrangements together with partial health-related benefits are tools intended to increase participation in work life. Although partial sickness benefit and partial disability pension are used in many countries, prospective studies on their use are largely lacking. Partial sickness benefit was introduced in Finland in 2007. This register study aimed to investigate the use of health-related benefits by subjects with prolonged sickness absence, initially on either partial or full sick leave. Representative population data (13 375 men and 16 052 women either on partial or full sick leave in 2007) were drawn from national registers and followed over an average of 18 months. The registers provided information on the study outcomes: diagnoses and days of payment for compensated sick leaves, and the occurrence of disability pension. Survival analysis and multinomial regression were carried out using sociodemographic variables and prior sickness absence as covariates. Approximately 60% of subjects on partial sick leave and 30% of those on full sick leave had at least one recurrent sick leave over the follow up. A larger proportion of those on partial sick leave (16%) compared to those on full sick leave (1%) had their first recurrent sick leave during the first month of follow up. The adjusted risks of the first recurrent sick leave were 1.8 and 1.7 for men and women, respectively, when subjects on partial sick leave were compared with those on full sick leave. There was no increased risk when those with their first recurrent sick leave in the first month were excluded from the analyses. The risks of a full disability pension were smaller and risks of a partial disability pension approximately two-fold among men and women initially on partial sick leave, compared to subjects on full sick leave. This is the first follow up study of the newly adopted partial sickness benefit in

  8. Associations between partial sickness benefit and disability pensions: initial findings of a Finnish nationwide register study

    Directory of Open Access Journals (Sweden)

    Luukkonen Ritva


    Full Text Available Abstract Background Timely return to work after longterm sickness absence and the increased use of flexible work arrangements together with partial health-related benefits are tools intended to increase participation in work life. Although partial sickness benefit and partial disability pension are used in many countries, prospective studies on their use are largely lacking. Partial sickness benefit was introduced in Finland in 2007. This register study aimed to investigate the use of health-related benefits by subjects with prolonged sickness absence, initially on either partial or full sick leave. Methods Representative population data (13 375 men and 16 052 women either on partial or full sick leave in 2007 were drawn from national registers and followed over an average of 18 months. The registers provided information on the study outcomes: diagnoses and days of payment for compensated sick leaves, and the occurrence of disability pension. Survival analysis and multinomial regression were carried out using sociodemographic variables and prior sickness absence as covariates. Results Approximately 60% of subjects on partial sick leave and 30% of those on full sick leave had at least one recurrent sick leave over the follow up. A larger proportion of those on partial sick leave (16% compared to those on full sick leave (1% had their first recurrent sick leave during the first month of follow up. The adjusted risks of the first recurrent sick leave were 1.8 and 1.7 for men and women, respectively, when subjects on partial sick leave were compared with those on full sick leave. There was no increased risk when those with their first recurrent sick leave in the first month were excluded from the analyses. The risks of a full disability pension were smaller and risks of a partial disability pension approximately two-fold among men and women initially on partial sick leave, compared to subjects on full sick leave. Conclusions This is the first follow

  9. Operative Technique and Clinical Outcome in Endoscopic Core Decompression of Osteochondral Lesions of the Talus: A Pilot Study


    Beck, Sascha; Cla?en, Tim; Haversath, Marcel; J?ger, Marcus; Landgraeber, Stefan


    Background Revitalizing the necrotic subchondral bone and preserving the intact cartilage layer by retrograde drilling is the preferred option for treatment of undetached osteochondral lesions of the talus (OLT). We assessed the effectiveness of Endoscopic Core Decompression (ECD) in treatment of OLT. Material/Methods Seven patients with an undetached OLT of the medial talar dome underwent surgical treatment using an arthroscopically-guided transtalar drill meatus for core decompression of th...

  10. Persistent sciatica induced by quadratus femoris muscle tear and treated by surgical decompression: a case report

    Directory of Open Access Journals (Sweden)

    Tzanakakis George


    Full Text Available Abstract Introduction Quadratus femoris tear is an uncommon injury, which is only rarely reported in the literature. In the majority of cases the correct diagnosis is delayed due to non-specific symptoms and signs. A magnetic resonance imaging scan is crucial in the differential diagnosis since injuries to contiguous soft tissues may present with similar symptoms. Presentation with sciatica is not reported in the few cases existing in the English literature and the reported treatment has always been conservative. Case presentation We report here on a case of quadratus femoris tear in a 22-year-old Greek woman who presented with persistent sciatica. She was unresponsive to conservative measures and so was treated with surgical decompression. Conclusion The correct diagnosis of quadratus muscle tear is a challenge for physicians. The treatment is usually conservative, but in cases of persistent sciatica surgical decompression is an alternative option.

  11. Magma degassing triggered by static decompression at Kīlauea Volcano, Hawai‘i (United States)

    Poland, Michael P.; Jeff, Sutton A.; Gerlach, Terrence M.


    During mid-June 2007, the summit of Kīlauea Volcano, Hawai‘i, deflated rapidly as magma drained from the subsurface to feed an east rift zone intrusion and eruption. Coincident with the deflation, summit SO2 emission rates rose by a factor of four before decaying to background levels over several weeks. We propose that SO2 release was triggered by static decompression caused by magma withdrawal from Kīlauea's shallow summit reservoir. Models of the deflation suggest a pressure drop of 0.5–3 MPa, which is sufficient to trigger exsolution of the observed excess SO2 from a relatively small volume of magma at the modeled source depth beneath Kīlauea's summit. Static decompression may also explain other episodes of deflation accompanied by heightened gas emission, including the precursory phases of Kīlauea's 2008 summit eruption. Hazards associated with unexpected volcanic gas emission argue for increased awareness of magma reservoir pressure fluctuations.

  12. Decompressive Abdominal Laparotomy for Abdominal Compartment Syndrome in an Unengrafted Bone Marrow Recipient with Septic Shock

    Directory of Open Access Journals (Sweden)

    Derrick J. N. Dauplaise


    Full Text Available Objective. To describe a profoundly immunocompromised (panleukopenia child with septic shock who developed abdominal compartment syndrome (ACS and was successfully treated with surgical decompression. Design. Individual case report. Setting. Pediatric intensive care unit of a tertiary children's hospital. Patient. A 32-month-old male with Fanconi anemia who underwent bone marrow transplantation (BMT 5 days prior to developing septic shock secondary to Streptococcus viridans and Escherichia coli ACS developed after massive fluid resuscitation, leading to cardiopulmonary instability. Interventions. Emergent surgical bedside laparotomy and silo placement. Measurements and Main Results. The patient's cardiopulmonary status stabilized after decompressive laparotomy. The abdomen was closed and the patient survived to hospital discharge without cardiac, respiratory, or renal dysfunction. Conclusions. The use of laparotomy and silo placement in an unengrafted BMT patient with ACS and septic shock did not result in additional complications. Surgical intervention for ACS is a reasonable option for high risk, profoundly immunocompromised patients.

  13. [Successful microvascular decompression of the medulla oblongata for a case with respiratory failure: case report]. (United States)

    Koguchi, Motofumi; Nakahara, Yukiko; Kawashima, Masatou; Takase, Yukinori; Matsushima, Toshio


    We report a case of the medulla oblongata syndrome successfully treated by microvascular decompression surgery. The patient was a 75-year-old woman and had been suffering from gradual progressive dyspnea since July, 2009. Two month later, intubation and medial ventilator treatments were began because of severe respiratory problems. The central respiratory problems were considered in extensive testing by the physician. The head MR imaging showed that the left vertebral artery had markedly compressed the medulla oblongata. We thought that her respiratory problems were associated with this vertebral artery compression of the medulla oblongata. We performed the microvascular decompression surgery by left trans-condylar fossa approach. Her hypoventilation graduately improved after the surgery and she needed neither ventilator nor oxygen in several months. She is able to perform daily activities by herself. We report the case, and discuss the cause of respiratory problems especially by compression of the medulla oblongata.

  14. MRI appearance of femoral head osteonecrosis following core decompression and bone grafting

    Energy Technology Data Exchange (ETDEWEB)

    Chan, T W; Dalinka, M K; Kressel, H Y [Pennsylvania Univ. Hospital, Philadelphia, PA (USA). Dept. of Radiology; Steinberg, M E [Pennsylvania Univ. Hospital, Philadelphia, PA (USA). Dept. of Orthopedic Surgery


    We used magnetic resonance imaging (MRI) to evaluate retrospectively 32 hips with avascular necrosis of the femoral head before and after core decompression and bone grafting. At a median follow-up time of 15 months, 4 of 9 large lesions had undergone femoral head collapse; 2 small lesions had decreased in size; and 14 small, 6 moderate, and 5 large lesions were unchanged. One hip with biopsy-proven avascular necrosis had diffuse marrow edema which resolved after surgery. The signal pattern within the lesions was analyzed in 17 hips. MRI can demonstrate changes in size and signal characteristics as well as femoral head collapse after core decompression and bone grafting. Changes in the surrounding marrow signal, including resolution of marrow edema and reconversion from fatty to hemopoietic marrow, can also be detected. (orig./GDG).

  15. Avascular bone necrosis: MR imaging findings before and after core decompression

    International Nuclear Information System (INIS)

    Adam, G.; Keulers, P.; Forst, J.; Neuerburg, J.; Kilbinger, M.; Guenther, R.W.


    17 patients with avascular epiphyseal necrosis were examined by MRI using T 1 -weighted spin echo sequences before and after gadopentetate dimeglumine application, T 2 -weighted spin echo sequences and in some patients with fat-saturated 2D gradient echo sequences up to 22 months after core decompression. All patients but one recovered from symptoms after core decompression. Although the signal morphology of the necrotic area remained unchanged in the majority of the cases, a decrease of the joint effusion was observed as well as an ongoing signal increase after gadopentetate dimeglumine application. The last examinations displayed similar signal characteristics as on the preoperative scans; however, a reduction of the necrotic zone became evident. (orig./MG) [de

  16. Developments in time-resolved high pressure x-ray diffraction using rapid compression and decompression

    International Nuclear Information System (INIS)

    Smith, Jesse S.; Sinogeikin, Stanislav V.; Lin, Chuanlong; Rod, Eric; Bai, Ligang; Shen, Guoyin


    Complementary advances in high pressure research apparatus and techniques make it possible to carry out time-resolved high pressure research using what would customarily be considered static high pressure apparatus. This work specifically explores time-resolved high pressure x-ray diffraction with rapid compression and/or decompression of a sample in a diamond anvil cell. Key aspects of the synchrotron beamline and ancillary equipment are presented, including source considerations, rapid (de)compression apparatus, high frequency imaging detectors, and software suitable for processing large volumes of data. A number of examples are presented, including fast equation of state measurements, compression rate dependent synthesis of metastable states in silicon and germanium, and ultrahigh compression rates using a piezoelectric driven diamond anvil cell

  17. Reducing sick leave of Dutch vocational school students: adaptation of a sick leave protocol using the intervention mapping process. (United States)

    de Kroon, Marlou L A; Bulthuis, Jozien; Mulder, Wico; Schaafsma, Frederieke G; Anema, Johannes R


    Since the extent of sick leave and the problems of vocational school students are relatively large, we aimed to tailor a sick leave protocol at Dutch lower secondary education schools to the particular context of vocational schools. Four steps of the iterative process of Intervention Mapping (IM) to adapt this protocol were carried out: (1) performing a needs assessment and defining a program objective, (2) determining the performance and change objectives, (3) identifying theory-based methods and practical strategies and (4) developing a program plan. Interviews with students using structured questionnaires, in-depth interviews with relevant stakeholders, a literature research and, finally, a pilot implementation were carried out. A sick leave protocol was developed that was feasible and acceptable for all stakeholders. The main barriers for widespread implementation are time constraints in both monitoring and acting upon sick leave by school and youth health care. The iterative process of IM has shown its merits in the adaptation of the manual 'A quick return to school is much better' to a sick leave protocol for vocational school students.

  18. Vection and visually induced motion sickness: How are they related?

    Directory of Open Access Journals (Sweden)

    Behrang eKeshavarz


    Full Text Available The occurrence of visually induced motion sickness has been frequently linked to the sensation of illusory self-motion (so-called vection, however, the precise nature of this relationship is still not fully understood. To date, it is still a matter of debate whether or not vection is a necessary prerequisite for visually induced motion sickness (VIMS. That is, can there be visually induced motion sickness without any sensation of self-motion? In this paper, we will describe the possible nature of this relationship, review the literature that may speak to this relationship (including theoretical accounts of vection and VIMS, and offer suggestions with respect to operationally defining and reporting these phenomena in future.

  19. Multidimensional intervention and sickness absence in assistant nursing students

    DEFF Research Database (Denmark)

    Svensson, Annemarie Lyng; Strøyer, Jesper; Ebbehøj, Niels Erik


    BACKGROUND: When handling patients, nursing assistant (NA) students and nurse students are frequently exposed to risk factors for low back pain (LBP) including sudden loads and twisting and bending of the spine. Furthermore, LBP is a major cause of sickness absence. AIMS: To ascertain...... if a multidimensional prevention programme combining physical training, patient transfer technique and stress management prevents sickness absence and LBP in NA students. METHODS: The study was a 14-month cluster randomized controlled study. The participants were NA students from 37 randomly selected classes located...... at two schools of health and social care in Copenhagen, Denmark. The participants completed a comprehensive questionnaire regarding sickness absence, LBP and psychosocial factors on commencement and after completion of the study. RESULTS: Of 766 female NA students, 668 (87%) completed the baseline...

  20. Evaluation of Outcome of Posterior Decompression and Instrumented Fusion in Lumbar and Lumbosacral Tuberculosis. (United States)

    Jain, Akshay; Jain, Ravikant; Kiyawat, Vivek


    For surgical treatment of lumbar and lumbosacral tuberculosis, the anterior approach has been the most popular approach because it allows direct access to the infected tissue, thereby providing good decompression. However, anterior fixation is not strong, and graft failure and loss of correction are frequent complications. The posterior approach allows circumferential decompression of neural elements along with three-column fixation attained via pedicle screws by the same approach. The purpose of this study was to evaluate the outcome (functional, neurological, and radiological) in patients with lumbar and lumbosacral tuberculosis operated through the posterior approach. Twenty-eight patients were diagnosed with tuberculosis of the lumbar and lumbosacral region from August 2012 to August 2013. Of these, 13 patients had progressive neurological deterioration or increasing back pain despite conservative measures and underwent posterior decompression and pedicle screw fixation with posterolateral fusion. Antitubercular therapy was given till signs of radiological healing were evident (9 to 16 months). Functional outcome (visual analogue scale [VAS] score for back pain), neurological recovery (Frankel grading), and radiological improvement were evaluated preoperatively, immediately postoperatively and 3 months, 6 months, and 1 year postoperatively. The mean VAS score for back pain improved from 7.89 (range, 9 to 7) preoperatively to 2.2 (range, 3 to 1) at 1-year follow-up. Frankel grading was grade B in 3, grade C in 7, and grade D in 3 patients preoperatively, which improved to grade D in 7 and grade E in 6 patients at the last follow-up. Radiological healing was evident in the form of reappearance of trabeculae formation, resolution of pus, fatty marrow replacement, and bony fusion in all patients. The mean correction of segmental kyphosis was 9.85° postoperatively. The mean loss of correction at final follow-up was 3.15°. Posterior decompression with instrumented

  1. Timing of Decompression in Patients With Acute Spinal Cord Injury: A Systematic Review


    Wilson, Jefferson R.; Tetreault, Lindsay A.; Kwon, Brian K.; Arnold, Paul M.; Mroz, Thomas E.; Shaffrey, Christopher; Harrop, James S.; Chapman, Jens R.; Casha, Steve; Skelly, Andrea C.; Holmer, Haley K.; Brodt, Erika D.; Fehlings, Michael G.


    Study Design: Systematic review. Objective: To conduct a systematic review and synthesis of the literature to assess the comparative effectiveness, safety, and cost-effectiveness of early (≤24 hours) versus late decompression (>24 hours) in adults with acute spinal cord injury (SCI). Methods: A systematic search was conducted of Medline, EMBASE, the Cochrane Collaboration Library, and Google Scholar to identify studies published through November 6, 2014. Studies published in any language, in ...

  2. Patent Foramen Ovale as a Risk Factor for Altitude Decompression Illness (United States)


    Medical Issues in Hypo-and Hyperbaric Conditions [les Questions medicales a caractere oprationel liees aux conditions hypobares ou hyperbares ] To order the...on "Operational Medical Issues in Hypo- and Hyperbaric Conditions ", held in Toronto, Canada, 16-19 October 2000, and published in RTO MP-062. 3-2...Space Environ Med 1996; 67: 1092-6. Powell MR, Norfleet WT, Kumar KV, Butler BD. Patent foramen ovale and hypobaric decompression. Aviat Space Environ

  3. Effect of decompressive hemicraniectomy on mortality of malignant middle cerebral artery infarction


    Bahram Aminmansour; Majeed Rezvany; Davood Sharifi; Hamidreza Shemshaki


    Background: Increasing intracranial pressure (ICP) is one of the leading causes of mortality in patients with malignant infarction of the middle cerebral artery (MCA). We prospectively evaluated patients with MCA infarction for one month survival after decompressive hemicraniectomy. Methods: This study was conducted at Alzahra University Hospital, Isfahan (Iran). Twenty patients with infarction in total MCA distribution area, resulting in midline shift of brain tissue for greater than 5mm...

  4. Management of sinonasal complications after endoscopic orbital decompression for Graves' orbitopathy. (United States)

    Antisdel, Jastin L; Gumber, Divya; Holmes, Janalee; Sindwani, Raj


    Endoscopic orbital decompression (EnOD) has proven to be safe and effective for the treatment of Graves' orbitopathy; however, complications do occur. Although the literature focuses on orbital complications, sinonasal complications including postobstructive sinusitis, hemorrhage, and cerebrospinal fluid (CSF) leak can also be challenging to manage. This study examines the incidence and management of sinonasal complications in these patients. Retrospective review. Clinical data, surgical findings, and postoperative outcomes were reviewed of patients who underwent EnOD for Graves' disease between March 2004 and November 2010. The incidence and management of postoperative sinonasal complications requiring an intervention were examined. The study group consisted of 50 consecutive patients (86 decompression procedures): 11 males and 39 females with an average age of 48.6 years (SD = 12.9). Incidence of significant sinonasal complications was 3.5% (5/86): with one patient experiencing postoperative hemorrhage requiring operative management, three patients with postoperative obstructive sinusitis, and one patient with nasal obstruction secondary to nasal adhesions that required lysis. The maxillary sinus was the most commonly involved and was managed using the mega-antrostomy technique. In the case of frontal sinusitis, an endoscopic transaxillary approach was utilized to avoid injury to decompressed orbital contents. All complications were successfully managed without sequelae. Sinonasal complications following EnOD are uncommon. In the setting of a decompressed orbit, even routine types of postoperative issues can be challenging and require additional considerations. Successful management of postoperative sinusitis related to outflow obstruction may require more extensive approaches and novel techniques. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  5. The Belgian End of Mission Transition Period: Lessons Learned from Third Location Decompression after Operational Deployment (United States)


    Third Location Decompression after Operational Deployment 11 - 2 RTO-MP-HFM-205 programs is based upon the literature on combat motivation ...exposure to normal leisure activities and tourism . Massage is another interesting element in the French program. Each soldier receives at least one... gastronomy ; during the French TLD, soldiers were allowed to drink wine or beer with their meal starting at 7pm and bars closed at 1am ultimately. Alcohol

  6. Early Autologous Cranioplasty after Decompressive Hemi-Craniectomy for Severe Traumatic Brain Injury

    International Nuclear Information System (INIS)

    Qasmi, S. A.; Ghaffar, A.; Hussain, Z.; Mushtaq, J.


    Objective: To evaluate the outcome of early replacement of autologous bone flap for decompressive hemicraniectomy in severe traumatic brain injury patients. Methods: The observational cross-sectional prospective study was conducted at the Neurosurgical Unit of the Combined Military Hospital, Rawalpindi, Pakistan, from July 2011, to June 2014, and comprised patients who underwent cranioplasty after decompressive hemicraniectomy for trauma. Patients over 20 years of age and of either gender were included. Cranioplasty was timed in all these patients using native bone flap preserved in the abdominal wall after decompressive craniectomy. Parameters recorded were mortality, wound infection, subdural collection, wound dehiscence, ventriculomegaly, bone resorption, cosmetic deformity and neurological outcome. SPSS 17 was used for data analysis. Results: Of the 30 patients in the study, 28(93.3 percent) were males. The overall mean age was age 32.03±8.01 years (range: 20-48 years). Mean cranioplasty time was 66.2±11.50 days (range: 44-89 days). Major infection necessitating bone flap removal was found in 1(3.33 percent) patient, while minor scalp wound infections, treated with antibiotics and dressings were found in 2(6.66 percent). Cosmetic18 deformity was seen in 3(10 percent). Improved neurological outcome was noted in 21(70 percent) patients; 6(20 percent) survived with a moderate to severe disability and 3(10 percent) remained in a vegetative state. No mortality was found after the procedure. Conclusion: Early autologous bone replacement for decompressive hemicraniectomy in severe traumatic brain injury patients offered cost-effective, acceptable surgical and improve dneurological outcome. (author)

  7. Macrovascular Decompression of the Brainstem and Cranial Nerves: Evolution of an Anteromedial Vertebrobasilar Artery Transposition Technique. (United States)

    Choudhri, Omar; Connolly, Ian D; Lawton, Michael T


    Tortuous and dolichoectatic vertebrobasilar arteries can impinge on the brainstem and cranial nerves to cause compression syndromes. Transposition techniques are often required to decompress the brainstem with dolichoectatic pathology. We describe our evolution of an anteromedial transposition technique and its efficacy in decompressing the brainstem and relieving symptoms. To present the anteromedial vertebrobasilar artery transposition technique for macrovascular decompression of the brainstem and cranial nerves. All patients who underwent vertebrobasilar artery transposition were identified from the prospectively maintained database of the Vascular Neurosurgery service, and their medical records were reviewed retrospectively. The extent of arterial displacement was measured pre- and postoperatively on imaging. Vertebrobasilar arterial transposition and macrovascular decompression was performed in 12 patients. Evolution in technique was characterized by gradual preference for the far-lateral approach, use of a sling technique with muslin wrap, and an anteromedial direction of pull on the vertebrobasilar artery with clip-assisted tethering to the clival dura. With this technique, mean lateral displacement decreased from 6.6 mm in the first half of the series to 3.8 mm in the last half of the series, and mean anterior displacement increased from 0.8 to 2.5 mm, with corresponding increases in satisfaction and relief of symptoms. Compressive dolichoectatic pathology directed laterally into cranial nerves and posteriorly into the brainstem can be corrected with anteromedial transposition towards the clivus. Our technique accomplishes this anteromedial transposition from an inferolateral surgical approach through the vagoaccessory triangle, with sling fixation to clival dura using aneurysm clips. Copyright © 2017 by the Congress of Neurological Surgeons

  8. Patent foramen ovale influences the presentation of decompression illness in SCUBA divers. (United States)

    Liou, Kevin; Wolfers, Darren; Turner, Robert; Bennett, Michael; Allan, Roger; Jepson, Nigel; Cranney, Greg


    Few have examined the influence of patent foramen ovale (PFO) on the phenotype of decompression illness (DCI) in affected divers. A retrospective review of our database was performed for 75 SCUBA divers over a 10-year period. Overall 4,945 bubble studies were performed at our institution during the study period. Divers with DCI were more likely to have positive bubble studies than other indications (pAustralia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  9. Measures of work-family conflict predict sickness absence from work. (United States)

    Clays, Els; Kittel, France; Godin, Isabelle; Bacquer, Dirk De; Backer, Guy De


    To examine the relation between work-family conflict and sickness absence. The BELSTRESS III study comprised 2983 middle-aged workers. Strain-based work-home interference (WHI) and home-work interference (HWI) were assessed by means of self-administered questionnaires. Prospective data of registered sickness absence during 12-months follow-up were collected. Multiple logistic regression analysis was conducted. HWI was positively and significantly related to high sickness absence duration (at least 10 sick leave days) and high sickness absence frequency (at least 3 sick leave episodes) in men and women, also after adjustments were made for sociodemographic variables, health indicators, and environmental psychosocial factors. In multivariate analysis, no association between WHI and sickness absence was found. HWI was positively and significantly related to high sickness absence duration and frequency during 12-months follow-up in male and female workers.

  10. Motion sickness and tilts of the inertial force environment : Active suspension systems vs. active passengers

    NARCIS (Netherlands)

    Golding, J. F.; van der Bles, W.; Bos, J. E.; Haynes, T.; Gresty, M. A.


    Background: Maneuvering in vehicles exposes occupants to low frequency forces (<1 Hz) which can provoke motion sickness. Hypothesis: Aligning with the tilting inertial resultant (gravity + imposed horizontal acceleration: gravito-inertial force (GIF)) may reduce motion sickness when tilting is

  11. The effect of part-time sick leave for employees with mental disorders

    DEFF Research Database (Denmark)

    Høgelund, Jan; Holm, Anders

    reduces the duration until employees with mental disorders end their sick leave by reporting ready for returning to regular working hours. The programme allows fully sick-listed employees to resume work at reduced hours. When the sick-listed employee’s health improves, working hours are increased until...... the employee is able to work regular hours. We use combined survey and register data about 226 long-term sick-listed employees with mental disorders and 638 employees with physical disorders. Our analyses show that part-time sick-listing significantly reduces the duration until returning to regular working...... hours for employees with physical disorders. In contrast, we find that part-time sick-listing does not reduce durations for employees with mental disorders. The analyses also illustrate the importance of adjusting for unobserved differences between part-time sick-listed and full-time sick...

  12. Autogenic feedback training experiment: A preventative method for space motion sickness (United States)

    Cowings, Patricia S.


    Space motion sickness is a disorder which produces symptoms similar to those of motion sickness on Earth. This syndrome has affected approximately 50 percent of all astronauts and cosmonauts exposed to microgravity in space, but it differs from what is commonly known as motion sickness in a number of critical ways. There is currently no ground-based method for predicting susceptibility to motion sickness in space. Antimotion sickness drugs have had limited success in preventing or counteracting symptoms in space, and frequently caused debilitating side effects. The objectives were: (1) to evaluate the effectiveness of Autogenic-Feedback Training as a countermeasure for space motion sickness; (2) to compare physiological data and in-flight symptom reports to ground-based motion sickness data; and (3) to predict susceptibility to space motion sickness based on pre-flight data of each treatment group crew member.

  13. Leadership styles of nurse managers and registered sickness absence among their nursing staff

    NARCIS (Netherlands)

    Schreuder, Jolanda A. H.; Roelen, Corne A. M.; van Zweeden, Nely F.; Jongsma, Dianne; van der Klink, Jac J. L.; Groothoff, Johan W.


    Background: Sickness absence leads to understaffing and interferes with nursing efficiency and quality. It has been reported in literature that managerial leadership is associated with self-reported sickness absence in the working population. Purposes: This study investigated the relationship

  14. Sleep disturbances and fatigue : independent predictors of sickness absence? A prospective study among 6538 employees

    NARCIS (Netherlands)

    Bultmann, Ute; Nielsen, Maj Britt D.; Madsen, Ida E. H.; Burr, Hermann; Rugulies, Reiner

    Background: Although sleep disturbances and fatigue are common conditions, frequently shown to be associated with sickness absence, only a few studies have prospectively investigated their independent effects on sickness absence, while adjusting for depressive symptoms. This study aims (i) to

  15. Total Facial Nerve Decompression for Severe Traumatic Facial Nerve Paralysis: A Review of 10 Cases

    Directory of Open Access Journals (Sweden)

    Sertac Yetiser


    Full Text Available Management of traumatic facial nerve disorders is challenging. Facial nerve decompression is indicated if 90–95% loss of function is seen at the very early period on ENoG or if there is axonal degeneration on EMG lately with no sign of recovery. Middle cranial or translabyrinthine approach is selected depending on hearing. The aim of this study is to present retrospective review of 10 patients with sudden onset complete facial paralysis after trauma who underwent total facial nerve decompression. Operation time after injury is ranging between 16 and105 days. Excitation threshold, supramaximal stimulation, and amplitude on the paralytic side were worse than at least %85 of the healthy side. Six of 11 patients had HBG-II, one patient had HBG-I, 3 patients had HBG-III, and one patient had HBG-IV recovery. Stretch, compression injuries with disruption of the endoneurial tubules undetectable at the time of surgery and lack of timely decompression may be associated with suboptimal results in our series.

  16. Nonaffine deformation under compression and decompression of a flow-stabilized solid (United States)

    Ortiz, Carlos P.; Riehn, Robert; Daniels, Karen E.


    Understanding the particle-scale transition from elastic deformation to plastic flow is central to making predictions about the bulk material properties and response of disordered materials. To address this issue, we perform experiments on flow-stabilized solids composed of micron-scale spheres within a microfluidic channel, in a regime where particle inertia is negligible. Each solid heap exists within a stress field imposed by the flow, and we track the positions of particles in response to single impulses of fluid-driven compression or decompression. We find that the resulting deformation field is well-decomposed into an affine field, with a constant strain profile throughout the solid, and a non-affine field. The magnitude of this non-affine response decays with the distance from the free surface in the long-time limit, suggesting that the distance from jamming plays a significant role in controlling the length scale of plastic flow. Finally, we observe that compressive pulses create more rearrangements than decompressive pulses, an effect that we quantify using the D\\text{min}2 statistic for non-affine motion. Unexpectedly, the time scale for the compression response is shorter than for decompression at the same strain (but unequal pressure), providing insight into the coupling between deformation and cage-breaking.

  17. Resolution of extra-axial collections after decompressive craniectomy for ischemic stroke. (United States)

    Ropper, Alexander E; Nalbach, Stephen V; Lin, Ning; Dunn, Ian F; Gormley, William B


    Extra-axial fluid collections are known consequences of decompressive hemicraniectomy. Studies have examined these collections and their management. We retrospectively reviewed 12 consecutive patients who underwent decompressive hemicraniectomy for the treatment of malignant cerebral edema after infarction and evaluated the evolution, resolution and treatment of post-operative extra-axial fluid collections. All patients underwent standard-sized frontotemporoparietal hemicraniectomy with duraplasty as treatment for medically intractable malignant cerebral edema at an average of 3 days after the stroke (median 2 days). Their 30-day mortality was 25%. Three patients developed some extra-axial fluid collections after craniectomy: two patients developed the collections early in their post-operative course, 3 days and 5 days after the craniectomy. Both experienced spontaneous resolution of the collections without corrective cranioplasty or shunt placement at 34 days and 58 days after surgery. The third patient developed a collection 55 days after the operation related to a subgaleal bacterial infection. In the final analysis, 18% of patients developed extra-axial collections and all resolved spontaneously. The incidence of extra-axial collections after decompressive hemicraniectomy following ischemic stroke was lower in our retrospective series than has been reported by others. The collections resolved spontaneously, suggesting that early anticipatory, corrective treatment with cerebrospinal fluid diversion or cranioplasty may not be warranted. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Effect of decompressive hemicraniectomy on mortality of malignant middle cerebral artery infarction

    Directory of Open Access Journals (Sweden)

    Bahram Aminmansour


    Full Text Available Background: Increasing intracranial pressure (ICP is one of the leading causes of mortality in patients with malignant infarction of the middle cerebral artery (MCA. We prospectively evaluated patients with MCA infarction for one month survival after decompressive hemicraniectomy. Methods: This study was conducted at Alzahra University Hospital, Isfahan (Iran. Twenty patients with infarction in total MCA distribution area, resulting in midline shift of brain tissue for greater than 5mm, underwent decompressive hemicraniectomy. Mortality rate was estimated one month after surgery. Results: Patients were 8 (40% males and 12 (60% females with a mean age of 49.9 ± 3.8 (25 to 70 years. Left and right MCA were involved in 7 (35% and 13 (65% patients, respectively. Four (20% patients died within one month after surgery (3 females and one male, mean age of 59.0 ± 4.5 vs. 47.6 ± 3.4 in survived patients, p < 0.001. The mean of baseline Glasscow Coma Scale (GCS score estimated 8.60 ± 1.55 in survived patients and 6.75 ± 0.95 in patients who died (p < 0.05. Conclusions: The survival rate of malignant MCA infarction treated with decompressive hemicraniectomy was the same as previous reports. MCA infarction mortality increased with age and lower admission GCS score.

  19. The effect of rapid decompression on femur blood flow of rabbits

    International Nuclear Information System (INIS)

    Yu Shaoning; Tian Wuxun; Zhu Xiangqi


    PURPOSE: To study the influence of regional blood flow in femur trochanter (FT) of rabbits' under rapid decompression after exposure to hyperbaric air. METHODS: Rabbits were placed in a hyperbaric chamber and exposed to the pressure of 0.5 MPa for 1.5 h, and the pressure was reduced to the atmosphere pressure at a uniform rate of 0.03 mPa/min. The regional blood flow of FT in rabbits were measured with 133 Xe washout methods. RESULTS: The normal average regional blood flow in left and right FT were 14.5 +- 1.7 and 14.1 +- 1.9 ml/(min·100g) respectively. After exposure to hyperbaric air with rapid decompression, the average regional blood flow of left and right FT were 11.1 +- 1.2 and 10.5 +- 1.6 ml/(min·100g) respectively. But the symptoms of dysbarism in these rabbits were various each other. CONCLUSIONS: After being exposed to hyperbaric air with rapid decompression, the blood flow of rabbits' femur trochanter were noticeably reduced

  20. Expansion of Chiari I-associated syringomyelia after posterior-fossa decompression. (United States)

    Gil, Z; Rao, S; Constantini, S


    Chiari I malformation (CMI) is an abnormality that involves caudal herniation of the cerebellar tonsils into the foramen magnum. CMI has been shown to be closely associated with the development of syringomyelia (SM). Several theories have emerged to explain the apparent correlation between the existence of CMI with subsequent development of SM. However, the exact mechanism of the evolution of SM is still subject to controversy. We report here the case of a 12-year-old girl admitted to hospital with headache, vomiting, ataxia, and moderate pyramidal signs. Radiological evaluation revealed the presence of CMI, accompanied by a small SM. The patient underwent posterior fossa decompression and improved significantly. She was re-admitted 6 months later with clinical evidence of progressive spinal cord dysfunction. MR revealed gross expansion of the syrinx. This case raises questions regarding the pathophysiology of CMI and its association with SM. The case indicates the need for neurological and radiological follow-up for patients undergoing posterior fossa decompression due to CMI, even for those without an initial syrinx. This is the first report known to us of expansion of a syrinx following decompression of an associated CMI.

  1. Technical and economic analysis of natural ga decompression: recovery of both electricity and process frigories

    International Nuclear Information System (INIS)

    Fracastoro, G.V.; Perino, M.


    The most significant results of the economic analysis on natural gas decompression, specifically referring to EniChem's newly built plant in Porto Marghera, are shown in this article. The analysis was carried out in the framework of rational utilization of energy in compliance with Law No.9 of January 9, 1991. In order to optimize the final use of energy, the service rendered being equal (natural gas was decompressed owing to safety and technical reasons), a possible solution was found, i.e. to replace thermodynamic lamination by an expansion process in a two-stage turbine expansor (recovery of physical energy in pressure). Thanks to this new solution, the above mentioned recovery operation can be integrated by recovering the frigories associated with the availability of the fluid stream (physical energy in temperature) at the outlet of the generator, in order to supply the refrigerating quantity needed to carry out some phases of the steam-cracking process, which takes place in an area lying close to the new decompression plant

  2. DSP accelerator for the wavelet compression/decompression of high- resolution images

    Energy Technology Data Exchange (ETDEWEB)

    Hunt, M.A.; Gleason, S.S.; Jatko, W.B.


    A Texas Instruments (TI) TMS320C30-based S-Bus digital signal processing (DSP) module was used to accelerate a wavelet-based compression and decompression algorithm applied to high-resolution fingerprint images. The law enforcement community, together with the National Institute of Standards and Technology (NISI), is adopting a standard based on the wavelet transform for the compression, transmission, and decompression of scanned fingerprint images. A two-dimensional wavelet transform of the input image is computed. Then spatial/frequency regions are automatically analyzed for information content and quantized for subsequent Huffman encoding. Compression ratios range from 10:1 to 30:1 while maintaining the level of image quality necessary for identification. Several prototype systems were developed using SUN SPARCstation 2 with a 1280 {times} 1024 8-bit display, 64-Mbyte random access memory (RAM), Tiber distributed data interface (FDDI), and Spirit-30 S-Bus DSP-accelerators from Sonitech. The final implementation of the DSP-accelerated algorithm performed the compression or decompression operation in 3.5 s per print. Further increases in system throughput were obtained by adding several DSP accelerators operating in parallel.

  3. Endoscopic resection of acetabular screw tip to decompress sciatic nerve following total hip arthroplasty. (United States)

    Yoon, Sun-Jung; Park, Myung-Sik; Matsuda, Dean K; Choi, Yun Ho


    Sciatic nerve injuries following total hip arthroplasty are disabling complications. Although degrees of injury are variable from neuropraxia to neurotmesis, mechanical irritation of sciatic nerve might be occurred by protruding hardware. This case shows endoscopic decompression for protruded acetabular screw irritating sciatic nerve, the techniques described herein may permit broader arthroscopic/endoscopic applications for management of complications after reconstructive hip surgery. An 80-year-old man complained of severe pain and paresthesias following acetabular component revision surgery. Physical findings included right buttock pain with radiating pain to lower extremity. Radiographs and computed tomography imaging showed that the sharp end of protruded screw invaded greater sciatic foramen anterior to posterior and distal to proximal direction at sciatic notch level. A protruding tip of the acetabular screw at the sciatic notch was decompressed by use of techniques gained from experience performing endoscopic sciatic nerve decompression. The pre-operative pain and paresthesias resolved post-operatively after recovering from anesthesia. This case report describes the first documented endoscopic resection of the tip of the acetabular screw irritating sciatic nerve after total hip arthroplasty. If endoscopic resection of an offending acetabular screw can be performed in a safe and minimally invasive manner, one can envision a future expansion of the role of hip arthroscopic surgery in several complications management after total hip arthroplasty.

  4. Is Sickness Presenteeism a Risk Factor for Depression?

    DEFF Research Database (Denmark)

    Conway, Paul Maurice; Hogh, Annie; Rugulies, Reiner Ernst


    was associated with an increased risk of depression among initially nondepressed participants (odds ratio, 2.45; 95% confidence interval, 1.06 to 5.64). No significant sex-related differences were observed in this relationship. CONCLUSION:: Adding to previous evidence on the health effects of SP, this study......OBJECTIVE:: To examine the prospective association between sickness presenteeism (SP), that is, working while ill, and the onset of depression. METHODS:: We carried out a two-wave (2006 to 2008) questionnaire-based study among 1271 employees from 60 Danish workplaces. Sickness presenteeism...... suggests that working while ill may also be a significant risk factor for the development of depression....

  5. Some determinants of sick leave for respiratory disease : Occupation, asthma, obesity, smoking and rehabilitation


    Nathell, Lennart


    The cost to society of sick leave and disability pensions is currently the most urgent economic problem in Sweden. The availability of a large sick-listing database, Collective Group Health Insurance, AGS (in Swedish: Avtalsgruppsjukförsäkring) provides a rare opportunity to study sick leave in Sweden. Periods of sick leave exceeding 14 days are recorded together with a mandatory diagnosis by a physician, gender, age, residential area, name of the employer, and occupation. ...

  6. Predictive validity of common mental disorders screening questionnaire as a screening instrument in long sickness absence

    DEFF Research Database (Denmark)

    Søgaard, Hans Jørgen; Bech, Per


    AIMS: Screening instruments for detection of common mental disorders have not been validity tested in long term sickness absence (LSA), which is the aim of this study for the Common Mental Disorders Screening Questionnaire (CMD-SQ). METHODS: Of all 2,414 incident persons on continuous sick...... in Denmark there is not a legal requirement that sick-listed persons are certified as sick by a physician....

  7. The effect on length of sickness absence by recognition of undetected psychiatric disorder in long-term sickness absence

    DEFF Research Database (Denmark)

    Søgaard, Hans Jørgen; Bech, Per


    of return to work. METHODS: Over one year all 2,414 incident persons on LSA in a well-defined population were within one week after eight weeks of continuous sickness absence posted the Common Mental Disorders Screening Questionnaire (CMD-SQ) to screen for mental disorders. In a randomized controlled trial...... (RCT), of 1,121 responding participants, persons with a minimum level of psychiatric symptoms 420 were allocated to the intervention group and 416 to the control group. The intervention was a psychiatric examination including diagnostics with Present State Examination and feedback regarding treatment...... to work. RESULTS: The rate of return to work was non-significantly lower for the intervention group than for the control group, except for persons without a psychiatric sick-leave diagnosis who were sick-listed from full time work, who showed a significantly higher rate of return to work...

  8. Associations of work ability with frequent and long-term sickness absence

    NARCIS (Netherlands)

    Notenbomer, A.; Groothoff, J. W.; van Rhenen, W.; Roelen, C. A. M.

    Background Reduced work ability is related to long-term sickness absence. The relationship between work ability and frequent sickness absence has not previously been investigated. It is important to distinguish between frequent and long-term sickness absence as they are outcomes of different

  9. Care for Sick Children as a Proxy for Gender Equality in the Family (United States)

    Eriksson, Rickard; Nermo, Magnus


    Swedish parents are entitled to government paid benefits to take care of sick children. In this paper we show that the gender distribution of paid care for sick children is a good proxy for the gender division of household work. Using two examples we show that registry data on care for sick children is a useful data source for studies on gender…

  10. Surgical decompression in endocrine orbitopathy. Visual evoked potential evaluation and effect on the optic nerve. (United States)

    Clauser, Luigi C; Tieghi, Riccardo; Galie', Manlio; Franco, Filippo; Carinci, Francesco


    Endocrine orbitopathy (EO) represents the most frequent and important extrathyroidal stigma of Graves disease. This chronic autoimmune condition involves the orbital contents, including extraocular muscles, periorbital connective-fatty tissue and lacrimal gland. The increase of fat tissue and the enlargement of extraocular muscles within the bony confines of the orbit leads to proptosis, and in the most severe cases optic neuropathy, caused by compression and stretching of the optic nerve. The congestion and the pressure of the enlarged muscles, constrict the nerve and can lead to reduced sight or loss of vision with the so called "orbital apex syndrome". Generally surgical treatment of EO, based on fat and/or orbital wall expansion, is possible and effective in improving exophthalmos and diplopia. Since there are limited reports focussing on optic neuropathy recovery after fat and/or orbital walls decompression the Authors decided to perform a retrospective analysis on a series of patients affected by EO. The study population was composed of 10 patients affected by EO and presenting to the Unit of Cranio Maxillofacial Surgery, Center for Craniofacial Deformities & Orbital Surgery St. Anna Hospital and University, Ferrara, Italy, for evaluation and treatment. A complete Visual Evoked Potentials (VEP) evaluation was performed. There were seven women and three men with a median age of 55 years. Optic nerve VEP amplitude and latency were recorded as normal or pathological. Abnormal results were scored as moderate, mild and severe. Differences in VEP pre and post-operatively were recorded as present or absent (i.e. VEP Delta). Pearson chi square test was applied. There were 20 operated orbits. The first VEP evaluation was performed 3.2 months before surgery and post-operative VEP control was done after a mean of 18.7 months. Fat decompression was performed in all cases and eight patients had also bony decompression. VEP amplitude and latency were affected in 10 and 15

  11. Osteonecrosis of femoral head: Treatment by core decompression and vascular pedicle grafting

    Directory of Open Access Journals (Sweden)

    Babhulkar Sudhir


    Full Text Available Background: Femoral head-preserving core decompression and bone grafting have shown excellent result in preventing collapse. The use of vascularized grafts have shown better clinical results. The vascular pedicle bone graft is an easy to perform operation and does not require special equipment. We analyzed and report a series of patients of osteonecrosis of femoral head treated by core decompression and vascular pedicle grafting of part of iliac crest based on deep circumflex iliac vessels. Materials and Methods: The article comprises of the retrospective study of 31 patients of osteonecrosis of femoral head in stage II and III treated with core decompression and vascular pedicle grafting by using part of iliac crest with deep circumflex iliac vessels from January 1990 to December 2005. The young patients with a mean age 32 years (18-52 years with a minimum follow-up of five years were included for analysis. Sixteen patients had osteonecrosis following alcohol abuse, 12 patients following corticosteroid consumption, 3 patients had idiopathic osteonecrosis. Nine patients were stage IIB, and 22 patients were stage IIIC according to ARCO′s system. The core decompression and vascular pedicle grafting was performed by anterior approach by using part of iliac crest with deep circumflex iliac vessels. Results: Digital subtraction arteriography performed in 9 patients at the end of 12 weeks showed the patency of deep circumflex artery in all cases, and bone scan performed in 6 other patients showed high uptake in the grafted area of the femoral head proving the efficacy of the operative procedure. Out of 31 patients, only one patient progressed to collapse and total joint replacement was advised. At the final follow up period of 5-8 years, Harris Hip Score improved mean ± SD of 28.2 ± 6.4 ( p < 0.05. Forty-eight percent of patients had an improvement in Harris Hip Score of more that 28 points. Conclusion: The core decompression and vascular pedicle

  12. Microvascular Decompression for Classical Trigeminal Neuralgia Caused by Venous Compression: Novel Anatomic Classifications and Surgical Strategy. (United States)

    Wu, Min; Fu, Xianming; Ji, Ying; Ding, Wanhai; Deng, Dali; Wang, Yehan; Jiang, Xiaofeng; Niu, Chaoshi


    Microvascular decompression of the trigeminal nerve is the most effective treatment for trigeminal neuralgia. However, when encountering classical trigeminal neuralgia caused by venous compression, the procedure becomes much more difficult, and failure or recurrence because of incomplete decompression may become frequent. This study aimed to investigate the anatomic variation of the culprit veins and discuss the surgical strategy for different types. We performed a retrospective analysis of 64 consecutive cases in whom veins were considered as responsible vessels alone or combined with other adjacent arteries. The study classified culprit veins according to operative anatomy and designed personalized approaches and decompression management according to different forms of compressive veins. Curative effects were assessed by the Barrow Neurological Institute (BNI) pain intensity score and BNI facial numbness score. The most commonly encountered veins were the superior petrosal venous complex (SPVC), which was artificially divided into 4 types according to both venous tributary distribution and empty point site. We synthetically considered these factors and selected an approach to expose the trigeminal root entry zone, including the suprafloccular transhorizontal fissure approach and infratentorial supracerebellar approach. The methods of decompression consist of interposing and transposing by using Teflon, and sometimes with the aid of medical adhesive. Nerve combing (NC) of the trigeminal root was conducted in situations of extremely difficult neurovascular compression, instead of sacrificing veins. Pain completely disappeared in 51 patients, and the excellent outcome rate was 79.7%. There were 13 patients with pain relief treated with reoperation. Postoperative complications included 10 cases of facial numbness, 1 case of intracranial infection, and 1 case of high-frequency hearing loss. The accuracy recognition of anatomic variation of the SPVC is crucial for the

  13. Sick-listing adherence: a register study of 1.4 million episodes of sickness benefit 2010-2013 in Sweden. (United States)

    Leijon, Ola; Josephson, Malin; Österlund, Niklas


    This register study aims to increase the knowledge on how common it is that sickness benefit recipients are sick-listed for as long as their physician prescribes in their medical sickness certificate, i.e. sick-listing adherence, or wholly/partly bring return-to-work (RTW) forward, i.e. early RTW. The unit for analysis was an episode of 100% sickness benefit, commenced between 1 January 2010 and 31 December 2013. Completed episodes of sickness benefit and full or partial early RTW was analysed by comparing the prescribed length of sick leave in medical sickness certificates and benefit days disbursed by the sickness insurance system. Probability for a full and partial early RTW was estimated with hazard ratio (HR) using the Cox proportional hazard model. In total, about 1.4 million episodes of sickness benefit (60% women) were included in the study. The overall sick-listing adherence was 84% for women and 82% for men during the first year of sick leave. Adherence varied between 82 and 87% among women and between 79 and 86% among men with regard to ICD-10 diagnosis chapter. The probability of an early RTW varied between diagnosis chapters, where mental disorders was associated with a lower probability of a full early RTW among women and men (HR 0.52 and HR 0.47) as well as a partial early RTW (HR 0.51 and HR 0.46). Younger age (16-29 years), high educational level and high income was associated with a higher probability of an early RTW, while older age (≥ 50 years), not native-born, low educational level, unemployment and parental leave were associated with a lower probability. The study demonstrates that sick-listing adherence is relatively high. Probability of an early RTW differs with regard to diagnosis chapter, demographic, socioeconomic and labour market characteristics of the sickness benefit recipients. Interventions intended to improve the sick-listing process, and to affect the length and degree of sick leave in certain target groups, should include

  14. Are environmental characteristics in the municipal eldercare, more closely associated with frequent short sick leave spells among employees than with total sick leave: a cross-sectional study (United States)


    Background It has been suggested that frequent-, short-term sick leave is associated with work environment factors, whereas long-term sick leave is associated mainly with health factors. However, studies of the hypothesis of an association between a poor working environment and frequent short spells of sick leave are few and results are inconsistent. Therefore, we aimed to explore associations between self-reported psychosocial work factors and workplace-registered frequency and length of sick leave in the eldercare sector. Methods Employees from the municipal eldercare in Aarhus (N = 2,534) were included. In 2005, they responded to a work environment questionnaire. Sick leave records from 2005 were dichotomised into total sick leave days (0–14 and above 14 days) and into spell patterns (0–2 short, 3–9 short, and mixed spells and 1–3 long spells). Logistic regression models were used to analyse associations; adjusted for age, gender, occupation, and number of spells or sick leave length. Results The response rate was 76%; 96% of the respondents were women. Unfavourable mean scores in work pace, demands for hiding emotions, poor quality of leadership and bullying were best indicated by more than 14 sick leave days compared with 0–14 sick leave days. For work pace, the best indicator was a long-term sick leave pattern compared with a non-frequent short-term pattern. A frequent short-term sick leave pattern was a better indicator of emotional demands (1.62; 95% CI: 1.1-2.5) and role conflict (1.50; 95% CI: 1.2-1.9) than a short-term non-frequent pattern. Age (= 40 years) statistically significantly modified the association between the 1–3 long-term sick leave spell pattern and commitment to the workplace compared with the 3–9 frequent short-term pattern. Conclusions Total sick leave length and a long-term sick leave spell pattern were just as good or even better indicators of unfavourable work factor scores than a frequent short-term sick leave

  15. Gambiense Sleeping Sickness In The Abraka Region Of Delta State ...

    African Journals Online (AJOL)

    Gambiense Sleeping Sickness In The Abraka Region Of Delta State, Nigeria: Passive Case Detection (Pcd) At The Baptist Medical Centre (BMC) Eku 1999 – 2004. ... The highest prevalence of infection was among patients aged between 26-35 years with 35.6% infection rate, 23.3 percent was recorded among those aged ...

  16. [Sick teachers? --Analysis of disability data from Mecklenburg-Vorpommern]. (United States)

    Meierjürgen, R; Paulus, P


    Based on a review of the latest research results on teachers' health, the review shows the extent as well as the structure of sick-leave of people working in schools in the Bundesland Mecklenburg-Vorpommern. Data concerning diseases of more than 7,000 employees who are insured by the Barmer Ersatzkasse were analysed. The results show that teachers are more often sick than all the persons insured by the Barmer Ersatzkasse. Differences between sexes show disadvantages for women. The sick-leave rates increase with age. Dominant diseases reflect very well the job routine of people working in schools: The most frequent diseases concern the respiratory organs, the skeleton, muscles and the connective tissue and mental illness issues; mental illnesses cause the longest periods of disablement. The conclusion refers to the restrictions of sick-leave statistics. It is argued that it is necessary to combine different data sources (e. g. work-place health reports) in order to get a more differentiated picture of factors of demand and strain on teachers' health.

  17. Psychosocial work factors and long sickness absence in Europe. (United States)

    Slany, Corinna; Schütte, Stefanie; Chastang, Jean-François; Parent-Thirion, Agnès; Vermeylen, Greet; Niedhammer, Isabelle


    Studies exploring a wide range of psychosocial work factors separately and together in association with long sickness absence are still lacking. The objective of this study was to explore the associations between psychosocial work factors measured following a comprehensive instrument (Copenhagen psychosocial questionnaire, COPSOQ) and long sickness absence (> 7 days/year) in European employees of 34 countries. An additional objective was to study the differences in these associations according to gender and countries. The study population consisted of 16 120 male and 16 588 female employees from the 2010 European working conditions survey. Twenty-five psychosocial work factors were explored. Statistical analysis was performed using multilevel logistic regression models and interaction testing. When studied together in the same model, factors related to job demands (quantitative demands and demands for hiding emotions), possibilities for development, social relationships (role conflicts, quality of leadership, social support, and sense of community), workplace violence (physical violence, bullying, and discrimination), shift work, and job promotion were associated with long sickness absence. Almost no difference was observed according to gender and country. Comprehensive prevention policies oriented to psychosocial work factors may be useful to prevent long sickness absence at European level.

  18. General introduction to altitude adaptation and mountain sickness

    DEFF Research Database (Denmark)

    Bartsch, P.; Saltin, B.


    ascent (average ascent rate 300 m/day above 2000 m a.s.l.), primarily in order to sleep and feel well, and minimize the risk of mountain sickness. A new classification of altitude levels based on the effects on performance and well-being is proposed and an overview given over the various modalities using...

  19. Reliability of psychophysiological responses across multiple motion sickness stimulation tests (United States)

    Stout, C. S.; Toscano, W. B.; Cowings, P. S.


    Although there is general agreement that a high degree of variability exists between subjects in their autonomic nervous system responses to motion sickness stimulation, very little evidence exists that examines the reproducibility of autonomic responses within subjects during motion sickness stimulation. Our objectives were to examine the reliability of autonomic responses and symptom levels across five testing occasions using the (1) final minute of testing, (2) change in autonomic response and the change in symptom level, and (3) strength of the relationship between the change in symptom level and the change in autonomic responses across the entire motion sickness test. The results indicate that, based on the final minute of testing, the autonomic responses of heart rate, blood volume pulse, and respiration rate are moderately stable across multiple tests. Changes in heart rate, blood volume pulse, respiration rate, and symptoms throughout the test duration are less stable across the tests. Finally, autonomic responses and symptom levels are significantly related across the entire motion sickness test.

  20. Motion Cues in Flight Simulation and Simulator Induced Sickness (United States)


    military F7 .. vehicles, surface excavation equipment, underground mining devices, railway locomotives, .A space vehicles, shiv bridges, and submarines. Of...Evaluatort Rleference to Fukuda is: Fukuda, T. Postural behavior and motion sickness. Acca Otolaryngol. (Stockholm), 1976, B1:37-241.) %kI RTD-5

  1. What bothers the sick-listed employee with severe MUPS?

    NARCIS (Netherlands)

    Hoedeman, R.; Blankenstein, A. H.; Koopmans, P. C.; Groothoff, J. W.

    Aims: The aim of this study was to explore what employees with severe medically unexplained physical symptoms (MUPS) experience as causes of distress with regard to employees with mild or no MUPS. Methods: This study is an additional analysis of a cross-sectional study in which 486 sick-listed

  2. Common mental disorders : Prediction of sickness absence durations and recurrences

    NARCIS (Netherlands)

    Kuper, Lammechiena


    Psychological disorders cause a considerable proportion of long-term sickness absence and constitute the most significant reason for disability pensions of employees under 55 years of age. Knowledge of the risk factors will help occupational physicians to initiate treatments and interventions at an


    NARCIS (Netherlands)

    Beemsterboer, Willibrord; Stewart, Roy; Groothoff, Johan; Nijhuis, Frans


    Objectives: A literature review for the years 1984-2004 was performed to identify the determinants of the sick leave frequency and duration over that period and to establish the continuity in the character of those determinants. Materials and Methods: The review referred to national and

  4. Pathophysiology of acute mountain sickness and high altitude pulmonary oedema

    DEFF Research Database (Denmark)

    Sutton, J R; Lassen, N


    We review the evidence that acute mountain sickness (AMS) and high altitude pulmonary oedema (HAPO) occur together more often than is realized. We hypothesize that AMS and HAPO have a common pathophysiological basis: both are due to increased pressure and flow in the microcirculation, causing...

  5. Potential non-pharmacological countermeasures for motion sickness

    NARCIS (Netherlands)

    Houben, M.M.J.; Bos, J.E.; Groen, E.L.


    Motion sickness can occur in any motion environment to which a person is not adapted, varying from cars, boats, and planes to fun rides and virtual reality. With symptoms such as nausea, vomiting, headache, lethargy, dizziness, and loss of concentration it causes discomfort for passengers but also a

  6. 20 CFR 335.2 - Manner of claiming sickness benefits. (United States)


    ..., or in the case of a female employee, pregnancy, miscarriage, or childbirth, an employee must file the... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Manner of claiming sickness benefits. 335.2 Section 335.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT...

  7. Mental disorder sick leave in Sweden: A population study. (United States)

    Lidwall, Ulrik; Bill, Sofia; Palmer, Edward; Olsson Bohlin, Christina


    The inability to perform productive work due to mental disorders is a growing concern in advanced societies. To investigate medically certified mental disorder and all-cause sick leave in a working population using demographic, socioeconomic and occupational predictors. The study population was the entire Swedish work force aged 16-64 years in December 31st 2011. The outcome was sick leave exceeding 14 days in 2012 with adjustment for 13 confounders. The risk of sick leave with a mental disorder is higher among women compared to men, among persons aged 30-39 and among parents in families with underage children. Employees in welfare service occupations within health care, education and social services have an elevated risk of mental disorder sick leave and constitute a large proportion of the workforce. The results support the need for improving early detection and prevention of mental disorders in the workforce. Improvements in psychosocial work environments are essential, where the higher risk in female dominated welfare occupations particularly, have repercussions on the quality of the welfare services provided for vulnerable groups in society. Better work-life balance in families with younger children could also mitigate the effects of a high total workload in that particular phase of life.

  8. Dose-response relation between physical activity and sick leave

    NARCIS (Netherlands)

    Proper, K.I.; Heuvel, S.G. van den; Vroome, E.M. de; Hildebrandt, V.H.; Beek, A.J. van der


    Objective: To investigate the dose-response relation between moderate and vigorous physical activity and sick leave in a working population. Methods: Data were used from three large Dutch databases: two continuous, cross sectional surveys among a representative sample of the Dutch population and one

  9. Effect of carbon dioxide in acute mountain sickness

    DEFF Research Database (Denmark)

    Harvey, T C; Raichle, M E; Winterborn, M H


    of the respiratory alkalosis normally seen at high altitude. Symptoms of acute mountain sickness were rapidly relieved. In three subjects cerebral blood flow increased by 17-39%, so that oxygen delivery to the brain would have been considerably improved. This study confirms earlier suggestions of the beneficial...

  10. Respiratory impact on motion sickness induced by linear motion

    NARCIS (Netherlands)

    Mert, A.; Klöpping-Ketelaars, I.; Bles, W.


    Motion sickness incidence (MSI) for vertical sinusoidal motion reaches a maximum at 0.167 Hz. Normal breathing frequency is close to this frequency. There is some evidence for synchronization of breathing with this stimulus frequency. If this enforced breathing takes place over a larger frequency

  11. Atrial fibrillation in patients with sick sinus syndrome

    DEFF Research Database (Denmark)

    Nielsen, Jens Cosedis; Thomsen, Poul Erik B; Højberg, Søren


    between minimal-paced programmed AVI = 100 and >100 ms (median value), respectively (P= 0.60).ConclusionsThe present study indicates that a longer baseline PQ-interval is associated with an increased risk of AF in patients with sick sinus syndrome. Atrial fibrillation burden is not associated...

  12. Management of Sick Leave due to Musculoskeletal Disorders

    NARCIS (Netherlands)

    E. Faber (Elske)


    textabstractMusculoskeletal disorders are a common problem that may lead to func-Ational limitations and (work) disability. It is not clear yet how improvement in Apain or functional limitations is related to return to work after an episode of sick Aleave. Furthermore, several physicians are

  13. Dexmedetomidine reduces lipopolysaccharide induced neuroinflammation, sickness behavior, and anhedonia.

    Directory of Open Access Journals (Sweden)

    Ching-Hua Yeh

    Full Text Available Peripheral innate immune response may induce sickness behavior through activating microglia, excessive cytokines production, and neuroinflammation. Dexmedetomidine (Dex has anti-inflammatory effect. We investigated the effects of Dex on lipopolysaccharide (LPS-induced neuroinflammation and sickness behavior in mice.BALB/c mice were intraperitoneally (i.p. injected with Dex (50 ug/kg or vehicle. One hour later, the mice were injected (i.p. with Escherichia coli LPS (0.33 mg/kg or saline (n = 6 in each group. We analyzed the food and water intake, body weight loss, and sucrose preference of the mice for 24h. We also determined microglia activation and cytokines expression in the brains of the mice. In vitro, we determine cytokines expression in LPS-treated BV-2 microglial cells with or without Dex treatment.In the Dex-pretreated mice, LPS-induced sickness behavior (anorexia, weight loss, and social withdrawal were attenuated and microglial activation was lower than vehicle control. The mRNA expression of TNF-α, MCP-1, indoleamine 2, 3 dioxygenase (IDO, caspase-3, and iNOS were increased in the brain of LPS-challenged mice, which were reduced by Dex but not vehicle.Dexmedetomidine diminished LPS-induced neuroinflammation in the mouse brain and modulated the cytokine-associated changes in sickness behavior.

  14. Sickness absenteeism at an all-time low

    NARCIS (Netherlands)

    Klein Hesselink, J.


    Absenteeism in the Netherlands rose steadily in the 1960s and 70s, driven by legislation that made it attractive for employees to take long-term sick leave. Changes in laws on absenteeism and disability seem to have been a driving force behind the fall in rates since the early 1980s and employers

  15. Is there a suburban sleeping sickness in Libreville? | Kohagne ...

    African Journals Online (AJOL)

    Background: The transmission of sleeping sickness occurs primarily in rural areas, and exposed populations are those living from rural activities such as agriculture, fishing, animal husbandry or hunting. However, urban and suburban foci are more and more reported in T. b. gambiense areas. In Libreville town, sleeping ...

  16. Development of a neural net paradigm that predicts simulator sickness

    Energy Technology Data Exchange (ETDEWEB)

    Allgood, G.O.


    A disease exists that affects pilots and aircrew members who use Navy Operational Flight Training Systems. This malady, commonly referred to as simulator sickness and whose symptomatology closely aligns with that of motion sickness, can compromise the use of these systems because of a reduced utilization factor, negative transfer of training, and reduction in combat readiness. A report is submitted that develops an artificial neural network (ANN) and behavioral model that predicts the onset and level of simulator sickness in the pilots and aircrews who sue these systems. It is proposed that the paradigm could be implemented in real time as a biofeedback monitor to reduce the risk to users of these systems. The model captures the neurophysiological impact of use (human-machine interaction) by developing a structure that maps the associative and nonassociative behavioral patterns (learned expectations) and vestibular (otolith and semicircular canals of the inner ear) and tactile interaction, derived from system acceleration profiles, onto an abstract space that predicts simulator sickness for a given training flight.

  17. The sweating sickness in England | Sloan | South African Medical ...

    African Journals Online (AJOL)

    An acute infect;ous fever, called the sweating sickness, broke out in England in five major epidemics in the years 1485, 1508, 1517, 1528 and 1551. Only one epidemic, that of 1528, spread also on the continent of Europe. The disease I-vas characterized by headache, pain in the chest, and profuse sweating, and frequently ...

  18. Surgical decompression for symptomatic Chiari II malformation in neonates with myelomeningocele

    NARCIS (Netherlands)

    Vandertop, W. P.; Asai, A.; Hoffman, H. J.; Drake, J. M.; Humphreys, R. P.; Rutka, J. T.; Becker, L. E.


    Between January, 1981, and July, 1991, 17 infants under 1 month of age were admitted to The Hospital for Sick Children with the signs and symptoms of a Chiari II malformation. These patients' presentation included swallowing difficulty (71%), stridor (59%), apneic spells (29%), aspiration (12%),

  19. Percutaneous laser disc decompression versus conventional microdiscectomy for patients with sciatica: Two-year results of a randomised controlled trial. (United States)

    Brouwer, Patrick A; Brand, Ronald; van den Akker-van Marle, M Elske; Jacobs, Wilco Ch; Schenk, Barry; van den Berg-Huijsmans, Annette A; Koes, Bart W; Arts, Mark A; van Buchem, M A; Peul, Wilco C


    Background Percutaneous laser disc decompression is a minimally invasive treatment, for lumbar disc herniation and might serve as an alternative to surgical management of sciatica. In a randomised trial with two-year follow-up we assessed the clinical effectiveness of percutaneous laser disc decompression compared to conventional surgery. Materials and methods This multicentre randomised prospective trial with a non-inferiority design, was carried out according to an intent-to-treat protocol with full institutional review board approval. One hundred and fifteen eligible surgical candidates, with sciatica from a disc herniation smaller than one-third of the spinal canal, were randomly allocated to percutaneous laser disc decompression ( n = 55) or conventional surgery ( n = 57). The main outcome measures for this trial were the Roland-Morris Disability Questionnaire for sciatica, visual analogue scores for back and leg pain and the patient's report of perceived recovery. Results The primary outcome measures showed no significant difference or clinically relevant difference between the two groups at two-year follow-up. The re-operation rate was 21% in the surgery group, which is relatively high, and with an even higher 52% in the percutaneous laser disc decompression group. Conclusion At two-year follow-up, a strategy of percutaneous laser disc decompression, followed by surgery if needed, resulted in non-inferior outcomes compared to a strategy of microdiscectomy. Although the rate of reoperation in the percutaneous laser disc decompression group was higher than expected, surgery could be avoided in 48% of those patients that were originally candidates for surgery. Percutaneous laser disc decompression, as a non-surgical method, could have a place in the treatment arsenal of sciatica caused by contained herniated discs.

  20. The effects of venting and decompression on Yellow Tang (Zebrasoma flavescens in the marine ornamental aquarium fish trade

    Directory of Open Access Journals (Sweden)

    Emily S. Munday


    Full Text Available Each year, over 45 countries export 30 million fish from coral reefs as part of the global marine ornamental aquarium trade. This catch volume is partly influenced by collection methods that cause mortality. Barotrauma in fish resulting from forced ascent from depth can contribute to post-collection mortality. However, implementing decompression stops during ascent can prevent barotrauma. Conversely, venting (puncturing the swim bladder to release expanded internal gas following ascent can mitigate some signs of barotrauma like positive buoyancy. Here, we evaluate how decompression and venting affect stress and mortality in the Yellow Tang (Zebrasoma flavescens. We examined the effects of three ascent treatments, each with decompression stops of varying frequency and duration, coupled with or without venting, on sublethal effects and mortality using histology and serum cortisol measurements. In fish subjected to ascent without decompression stops or venting, a mean post-collection mortality of 6.2% occurred within 24 h of capture. Common collection methods in the fishery, ascent without decompression stops coupled with venting, or one long decompression stop coupled with venting, resulted in no mortality. Histopathologic examination of heart, liver, head kidney, and swim bladder tissues in fish 0d and 21d post-collection revealed no significant barotrauma- or venting-related lesions in any treatment group. Ascent without decompression stops resulted in significantly higher serum cortisol than ascent with many stops, while venting alone did not affect cortisol. Future work should examine links in the supply chain following collection to determine if further handling and transport stressors affect survivorship and sublethal effects.

  1. Enough positive rate of paraspinal mapping and diffusion tensor imaging with levels which should be decompressed in lumbar spinal stenosis. (United States)

    Chen, Hua-Biao; Zhong, Zhi-Wei; Li, Chun-Sheng; Bai, Bo


    In lumbar spinal stenosis, correlating symptoms and physical examination findings with decompression levels based on common imaging is not reliable. Paraspinal mapping (PM) and diffusion tensor imaging (DTI) may be possible to prevent the false positive occurrences with MRI and show clear benefits to reduce the decompression levels of lumbar spinal stenosis than conventional magnetic resonance imaging (MRI) + neurogenic examination (NE). However, they must have enough positive rate with levels which should be decompressed at first. The study aimed to confirm that the positive of DTI and PM is enough in levels which should be decompressed in lumbar spinal stenosis. The study analyzed the positive of DTI and PM as well as compared the preoperation scores to the postoperation scores, which were assessed preoperatively and at 2 weeks, 3 months 6 months, and 12 months postoperatively. 96 patients underwent the single level decompression surgery. The positive rate among PM, DTI, and (PM or DTI) was 76%, 98%, 100%, respectively. All post-operative Oswestry Disability Index (ODI), visual analog scale for back pain (VAS-BP) and visual analog scale for leg pain (VAS-LP) scores at 2 weeks postoperatively were measured improvement than the preoperative ODI, VAS-BP and VAS-LP scores with statistically significance (p-value = 0.000, p-value = 0.000, p-value = 0.000, respectively). In degenetive lumbar spinal stenosis, the positive rate of (DTI or PM) is enough in levels which should be decompressed, thence using the PM and DTI to determine decompression levels will not miss the level which should be operated. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  2. Part-time sick leave as a treatment method for individuals with musculoskeletal disorders


    Andrén, Daniela; Svensson, Mikael


    There is increasing evidence that staying active is an important part of a recovery process for individuals on sick leave due to musculoskeletal disorders (MSDs). It has been suggested that using part-time sick-leave rather than full-time sick leave will enhance the possibility of full recovery to the workforce, and several countries actively favor this policy. However, to date only few studies have estimated the effect of using part-time sick leave in contrast to full-time sick leave. In thi...

  3. Ventilation in day-care centres and sick leave among nursery children

    DEFF Research Database (Denmark)

    Kolarik, Barbara; Andersen, Zorana Jovanovic; Ibfelt, Tobias


    ventilation in DCCs and sick leave among nursery children. Data on child sick leave within an 11 week period was obtained for 635 children attending 20 DCCs. Ventilation measurements included three proxies of ventilation: air exchange rate (ACR) measured with the decay method, ACR measured...... inverse relationship between the number of sick days and ACR measured with the decay method was found for crude and adjusted analysis, with a 12% decrease in number of sick days per 1 h(-1) increase in ACR measured with the decay method. This study suggests a relationship between sick leave among nursery...

  4. Longitudinal associations of active commuting with wellbeing and sickness absence. (United States)

    Mytton, Oliver Tristan; Panter, Jenna; Ogilvie, David


    Our aim was to explore longitudinal associations of active commuting (cycling to work and walking to work) with physical wellbeing (PCS-8), mental wellbeing (MCS-8) and sickness absence. We used data from the Commuting and Health in Cambridge study (2009 to 2012; n=801) to test associations between: a) maintenance of cycling (or walking) to work over a one year period and indices of wellbeing at the end of that one year period; and b) associations between change in cycling (or walking) to work and change in indices of wellbeing. Linear regression was used for testing associations with PCS-8 and MCS-8, and negative binomial regression for sickness absence. After adjusting for sociodemographic variables, physical activity and physical limitation, those who maintained cycle commuting reported lower sickness absence (0.46, 95% CI: 0.14-0.80; equivalent to one less day per year) and higher MCS-8 scores (1.50, 0.10-2.10) than those who did not cycle to work. The association for sickness absence persisted after adjustment for baseline sickness absence. No significant associations were observed for PCS-8. Associations between change in cycle commuting and change in indices of wellbeing were not significant. No significant associations were observed for walking. This work provides some evidence of the value of cycle commuting in improving or maintaining the health and wellbeing of adults of working age. This may be important in engaging employers in the promotion of active travel and communicating the benefits of active travel to employees. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  5. Comparison of treatment strategies for Space Motion Sickness (United States)

    Davis, J. R.; Jennings, R. T.; Beck, B. G.


    Treatment strategies for Space Motion Sickness were compared using the results of postflight oral debriefings. Standardized questionnaires were administered to all crewmembers immediately following Space Shuttle flights by NASA flight surgeons. Cases of Space Motion Sickness were graded as mild, moderate or severe based on published criteria, and medication effectiveness was judged based on subjective reports of symptom relief. Since October 1989, medication effectiveness is reported inflight through Private Medical Conferences with the crew. A symptom matrix was analyzed for 19 crewmembers treated with an oral combination of scopolamine and dextroamphetamine (scopdex) and 15 crewmembers treated with promethazine delivered by intramuscular (IM) or suppository routes. Scopdex has been given preflight as prophaxis for Space Motion Sickness but analysis showed delayed symptom presentation in 9 crewmembers or failed to prevent symptoms in 7. Only three crewmembers who took scopdex had no symptoms inflight. Fourteen out of 15 crewmembers treated with IM promethazine and 6 of 8 treated with promethazine suppositories after symptom development had immediate (within 12 h) symptom relief and required no additional medication. There were no cases of delayed symptom presentation in the crewmembers treated with promethazine. This response is in contrast to untreated crewmembers who typically have slow symptom resolution over 72-96 h. We conclude that promethazine is an effective treatment of Space Motion Sickness symptoms inflight. NASA policy currently recommends treating crewmembers with Space Motion Sickness after symptom development, and no longer recommends prophylaxis with scopdex due to delayed symptom development and apparent variable absorption of oral medications during early flight days.

  6. Predictors of recurrent sickness absence among workers having returned to work after sickness absence due to common mental disorders

    NARCIS (Netherlands)

    Arends, I.; van der Klink, J.J.L.; van Rhenen, W.; de Boer, M.R.; Bultmann, U.


    Objective The aim of this study was to investigate whether sociodemographic, disease-related, personal, and work-related factors - measured at baseline - are predictors of recurrent sickness absence (SA) at 6 and 12 months follow-up among workers who returned to work after SA due to common mental

  7. Predictors of recurrent sickness absence among workers having returned to work after sickness absence due to common mental disorders

    NARCIS (Netherlands)

    Arends, Iris; van der Klink, Jac J. L.; van Rhenen, Willem; de Boer, Michiel R.; Bultmann, Ute

    Objective The aim of this study was to investigate whether sociodemographic, disease-related, personal, and work-related factors - measured at baseline - are predictors of recurrent sickness absence (SA) at 6 and 12 months follow-up among workers who returned to work after SA due to common mental

  8. Sick leave and depression - determining factors and clinical effect in outpatient care. (United States)

    Bermejo, Isaac; Kriston, Levente; Schneider, Frank; Gaebel, Wolfgang; Hegerl, Ulrich; Berger, Mathias; Härter, Martin


    Sickness leave is a major source of societal costs in depression treatment. However, very little is known about the rationale behind sick leave and their effects on depressive symptoms. Aim of the paper is to evaluate the effect of sick leave on treatment outcome and the association of sick leave with patient, depression and treatment-related factors. For this we compared patients with sick leave and non-sick leave regarding symptom reduction following 6 weeks of treatment. A total of 118 patients of 41 physicians in a controlled clinical trial with a naturalistic prospective design were analysed. After 8 weeks of treatment no significant differences were found between patients who had or did not have sick leave, in terms of improvement of depressive symptoms. The analyses of physician, patient and illness-related variables regarding their predictive value showed no significant effect. No systematic effect of sick leave and no clear criteria were found that were related to receiving a sick leave certificate. It can be assumed that physicians do not only base the decision of whether to sign a depressive patient off sick on illness-specific factors. For a targeted implementation of sick leave as therapeutic measure predictors for effectiveness should be defined. Copyright © 2010 Elsevier Ltd. All rights reserved.

  9. Does evening work predict sickness absence among female carers of the elderly?

    DEFF Research Database (Denmark)

    Tüchsen, Finn; Christensen, Karl Bang; Nabe-Nielsen, Kirsten


    OBJECTIVES: The aim of the present study was to predict the risk ratio of sickness absence lasting > or = 2 weeks due to shift work among Danish workers caring for the elderly during the evening and at night. METHODS: A sample of Danish carers of the elderly were interviewed in 2005. The response...... rate was 78%. A cohort of 5627 shift and day workers was followed for sickness absence lasting > or = 2 weeks and for sickness absence lasting > or = 8 weeks in a sickness compensation register covering all social transfer payments in Denmark. RESULTS: Among the evening workers, the rate ratio (RR......) of sickness absence lasting > or = 2 weeks was 1.29 (95% confidence interval (95% CI) 1.10-1.52). The rate ratio for sickness absence lasting > or = 8 weeks was 1.24 (95% CI 0.99-1.56). CONCLUSIONS: Evening work may cause long-term sickness absence lasting > or = 2 weeks....

  10. Facial nerve decompression surgery using bFGF-impregnated biodegradable gelatin hydrogel in patients with Bell palsy. (United States)

    Hato, Naohito; Nota, Jumpei; Komobuchi, Hayato; Teraoka, Masato; Yamada, Hiroyuki; Gyo, Kiyofumi; Yanagihara, Naoaki; Tabata, Yasuhiko


    Basic fibroblast growth factor (bFGF) promotes the regeneration of denervated nerves. The aim of this study was to evaluate the regeneration-facilitating effects of novel facial nerve decompression surgery using bFGF in a gelatin hydrogel in patients with severe Bell palsy. Prospective clinical study. Tertiary referral center. Twenty patients with Bell palsy after more than 2 weeks following the onset of severe paralysis were treated with the new procedure. The facial nerve was decompressed between tympanic and mastoid segments via the mastoid. A bFGF-impregnated biodegradable gelatin hydrogel was placed around the exposed nerve. Regeneration of the facial nerve was evaluated by the House-Brackmann (H-B) grading system. The outcomes were compared with the authors' previous study, which reported outcomes of the patients who underwent conventional decompression surgery (n = 58) or conservative treatment (n = 43). The complete recovery (H-B grade 1) rate of the novel surgery (75.0%) was significantly better than the rate of conventional surgery (44.8%) and conservative treatment (23.3%). Every patient in the novel decompression surgery group improved to H-B grade 2 or better even when undergone between 31 and 99 days after onset. Advantages of this decompression surgery are low risk of complications and long effective period after onset of the paralysis. To the authors' knowledge, this is the first clinical report of the efficacy of bFGF using a new drug delivery system in patients with severe Bell palsy.

  11. Simulation of gas bubbles in hypobaric decompressions: roles of O2, CO2, and H2O. (United States)

    Van Liew, H D; Burkard, M E


    To gain insight into the special features of bubbles that may form in aviators and astronauts, we simulated the growth and decay of bubbles in two hypobaric decompressions and a hyperbaric one, all with the same tissue ratio (TR), where TR is defined as tissue PN2 before decompression divided by barometric pressure after. We used an equation system which is solved by numerical methods and accounts for simultaneous diffusion of any number of gases as well as other major determinants of bubble growth and absorption. We also considered two extremes of the number of bubbles which form per unit of tissue. A) Because physiological mechanisms keep the partial pressures of the "metabolic" gases (O2, CO2, and H2O) nearly constant over a range of hypobaric pressures, their fractions in bubbles are inversely proportional to pressure and their large volumes at low pressure add to bubble size. B) In addition, the large fractions facilitate the entry of N2 into bubbles, and when bubble density is low, enhance an autocatalytic feedback on bubble growth due to increasing surface area. C) The TR is not closely related to bubble size; that is when two different decompressions have the same TR, metabolic gases cause bubbles to grow larger at lower hypobaric pressures. We conclude that the constancy of partial pressures of metabolic gases, unimportant in hyperbaric decompressions, affects bubble size in hypobaric decompressions in inverse relation to the exposure pressure.

  12. Transcranial doppler sonography in two patients who underwent decompressive craniectomy for traumatic brain swelling: report of two cases

    Directory of Open Access Journals (Sweden)

    Bor-Seng-Shu Edson


    Full Text Available The role of decompressive craniectomy in the treatment of severe posttraumatic cerebral swelling remains quite a controversial issue. To the best of our knowledge, there is no study demonstrating the effect of decompressive craniectomy on cerebral blood flow (CBF velocity by means of transcranial Doppler sonography (TCD. We present two patients who developed traumatic brain swelling and uncontrollable intracranial hypertension with coma and signs of transtentorial herniation. One patient underwent bifrontal, while the second, unilateral, frontotemporoparietal decompressive craniectomy with dural expansion. In both patients, TCD examinations were performed immediately before and after surgery to study the cerebral hemodynamic changes related to the operations. Pre and postoperative TCD examinations demonstrated a significant increase in blood flow velocity in the intracranial arteries in both subjects. In conclusion, our cases suggest that decompressive craniectomy with dural expansion may result in elevation of CBF velocity in patients with massive brain swelling. The increase in CBF velocity appears to occur not only in the decompressed hemisphere, but also on the opposite side.

  13. The effect of partial portal decompression on portal blood flow and effective hepatic blood flow in man: a prospective study. (United States)

    Rosemurgy, A S; McAllister, E W; Godellas, C V; Goode, S E; Albrink, M H; Fabri, P J


    With the advent of transjugular intrahepatic porta-systemic stent shunt and the wider application of the surgically placed small diameter prosthetic H-graft portacaval shunt (HGPCS), partial portal decompression in the treatment of portal hypertension has received increased attention. The clinical results supporting the use of partial portal decompression are its low incidence of variceal rehemorrhage due to decreased portal pressures and its low rate of hepatic failure, possibly due to maintenance of blood flow to the liver. Surprisingly, nothing is known about changes in portal hemodynamics and effective hepatic blood flow following partial portal decompression. To prospectively evaluate changes in portal hemodynamics and effective hepatic blood flow brought about by partial portal decompression, the following were determined in seven patients undergoing HGPCS: intraoperative pre- and postshunt portal vein pressures and portal vein-inferior vena cava pressure gradients, intraoperative pre- and postshunt portal vein flow, and pre- and postoperative effective hepatic blood flow. With HGPCS, portal vein pressures and portal vein-inferior vena cava pressure gradients decreased significantly, although portal pressures remained above normal. In contrast to the significant decreases in portal pressures, portal vein blood flow and effective hepatic blood flow do not decrease significantly. Changes in portal vein pressures and portal vein-inferior vena cava pressure gradients are great when compared to changes in portal vein flow and effective hepatic blood flow. Reduction of portal hypertension with concomitant maintenance of hepatic blood flow may explain why hepatic dysfunction is avoided following partial portal decompression.

  14. Dynamics of upper mantle rocks decompression melting above hot spots under continental plates (United States)

    Perepechko, Yury; Sorokin, Konstantin; Sharapov, Victor


    Numeric 2D simulation of the decompression melting above the hot spots (HS) was accomplished under the following conditions: initial temperature within crust mantle section was postulated; thickness of the metasomatized lithospheric mantle is determined by the mantle rheology and position of upper asthenosphere boundary; upper and lower boundaries were postulated to be not permeable and the condition for adhesion and the distribution of temperature (1400-2050°C); lateral boundaries imitated infinity of layer. Sizes and distribution of lateral points, their symmetry, and maximum temperature varied between the thermodynamic condition for existences of perovskite - majorite transition and its excess above transition temperature. Problem was solved numerically a cell-vertex finite volume method for thermo hydrodynamic problems. For increasing convergence of iterative process the method of lower relaxation with different value of relaxation parameter for each equation was used. The method of through calculation was used for the increase in the computing rate for the two-layered upper mantle - lithosphere system. Calculated region was selected as 700 x (2100-4900) km. The time step for the study of the asthenosphere dynamics composed 0.15-0.65 Ma. The following factors controlling the sizes and melting degree of the convective upper mantle, are shown: a) the initial temperature distribution along the section of upper mantleb) sizes and the symmetry of HS, c) temperature excess within the HS above the temperature on the upper and lower mantle border TB=1500-2000oC with 5-15% deviation but not exceed 2350oC. It is found, that appearance of decompression melting with HS presence initiate primitive mantle melting at TB > of 1600oC. Initial upper mantle heating influence on asthenolens dimensions with a constant HS size is controlled mainly by decompression melting degree. Thus, with lateral sizes of HS = 400 km the decompression melting appears at TB > 1600oC and HS

  15. The results of decompressive surgery and instrumented posterolateral fusion in refractory degenerative spondylolisthesis

    Directory of Open Access Journals (Sweden)

    Behtash H


    Full Text Available "nBackground: Degenerative spondylolisthesis is a common disease of the lumbar spine especially in older ones. The disease represents a challenge to the treating physician. At present, for those patients that deteriorate clinically, there are many proposed algorithms for the surgical treatment. This before and after study was undertaken to assess the surgical results of decompression and instrumented posterolateral fusion in these patients. "nMethods: The study population consisted of 23 patients who had undergone no prior surgery for degenerative spondylolisthesis on the lumbar spine. These patients were treated by decompression, bilateral posterolateral fusion, and segmental (pedicle screw instrumentation with mean follow-up of 29 months (range, 13-73 months. Finally, The clinical results were evaluated for all patients by means of an Oswestry Disability Index (ODI version 2.1, the Henderson's functional capacity, and persistence of leg symptoms, low back pain or claudication. Mann-Whitney and Chi-Square tests were used to assess the average values and comparison, respectively. "nResults: Henderson's functional capacity at the last visit session was excellent in 14 (60.9%, good in 7 (30.4%, fair in 2 (8.7% cases. ODI decreased from 72.2% (50-88% preoperatively to 14.4% (0-54% at the latest follow-up visit. A history of leg pain or claudication was correlated significantly with the amount of decline in ODI score and Henderson's functional capacity (p<0.05. "nConclusion: In spite of limited number of our patients, decompressive surgery plus instrumented posterolateral fusion is a safe, reliable, and satisfactory procedure for treating degenerative lumbar spondylolisthesis. This procedure may be done when conservative treatment was failed and psychological problems can be ruled out.

  16. Unilateral Approach for Bilateral Decompression of Lumbar Spinal Stenosis: A Minimal Invasive Surgery

    International Nuclear Information System (INIS)

    Usman, M.; Ali, M.; Khanzada, K.; Haq, N.U.; Aman, R.; Ali, M.


    Objective: To assess the feasibility and efficacy of a novel, minimally invasive spinal surgery technique for the correction of lumbar spinal stenosis involving unilateral approach for bilateral decompression. Study Design: Cross-sectional observational study. Place and Duration of Study: Neurosurgery Department of PGMI, Lady Reading Hospital, Peshawar, from January to December 2010. Methodology: A total of 60 patients with lumbar stenosis were randomly assigned to undergo either a conventional laminectomy (30 patients, Group A), or a unilateral approach (30 patients, Group B). Clinical outcomes was measured using the scale of Finneson and Cooper. All the data was collected by using a proforma and different parameters were assessed for a minimum follow-up period of three months. Data was analyzed by descriptive statistics using SPSS software version 17. Results: Adequate decompression was achieved in all patients. Compared with patients in the conventional laminectomy group, patients who received the novel procedure (unilateral approach) had a reduced mean duration of hospital stay, a faster recovery rate and majority of the patients (88.33%) had an excellent to fair operative result according to the Finneson and Cooper scale. Five major complications occurred in all patient groups, 2 patients had unintended dural rent and 2 wound dehiscence each and fifth patient had worsening of symptoms. There was no mortality in the series. Conclusion: The ultimate goal of the unilateral approach to treat lumbar spinal stenosis is to achieve adequate decompression of the neural elements. An additional benefit of a minimally invasive approach is adequate preservation of vertebral stability, as it requires only minimal muscle trauma, preservation of supraspinous/intraspinous ligament complex and spinous process, therefore, allows early mobilization. This also shortens the hospital stay, reduces postoperative back pain, and leads to satisfactory outcome. (author)

  17. Anterior versus lateral needle decompression of tension pneumothorax: comparison by computed tomography chest wall measurement. (United States)

    Sanchez, Leon D; Straszewski, Shannon; Saghir, Amina; Khan, Atif; Horn, Erin; Fischer, Christopher; Khosa, Faisal; Camacho, Marc A


    Recent research describes failed needle decompression in the anterior position. It has been hypothesized that a lateral approach may be more successful. The aim of this study was to identify the optimal site for needle decompression. A retrospective study was conducted of emergency department (ED) patients who underwent computed tomography (CT) of the chest as part of their evaluation for blunt trauma. A convenience sample of 159 patients was formed by reviewing consecutive scans of eligible patients. Six measurements from the skin surface to the pleural surface were made for each patient: anterior second intercostal space, lateral fourth intercostal space, and lateral fifth intercostal space on the left and right sides. The distance from skin to pleura at the anterior second intercostal space averaged 46.3 mm on the right and 45.2 mm on the left. The distance at the midaxillary line in the fourth intercostal space was 63.7 mm on the right and 62.1 mm on the left. In the fifth intercostal space the distance was 53.8 mm on the right and 52.9 mm on the left. The distance of the anterior approach was statistically less when compared to both intercostal spaces (p < 0.01). With commonly available angiocatheters, the lateral approach is less likely to be successful than the anterior approach. The anterior approach may fail in many patients as well. Longer angiocatheters may increase the chances of decompression, but would also carry a higher risk of damage to surrounding vital structures. © 2011 by the Society for Academic Emergency Medicine.

  18. The urgency of surgical decompression in acute central cord injuries with spondylosis and without instability. (United States)

    Lenehan, Brian; Fisher, Charles G; Vaccaro, Alex; Fehlings, Michael; Aarabi, Bizhan; Dvorak, Marcel F


    Systematic review, ambispective analysis of observational data. To make recommendations as to whether or not urgent surgical decompression is ever indicated as the optimal treatment for enhancing neurologic recovery in a patient with acute central cord injury without fracture or instability. There are currently no standards regarding the role and timing of decompression in acute traumatic central cord syndrome. In the setting of TCCS without spinal column instability, much controversy exists. We have performed a thorough literature search based on the following question: "Is there a role for urgent (within 24 hours from injury to surgery) surgical decompression in acute central cord syndrome without fracture or instability specifically to enhance neurologic recovery?" Data including patient demographics, mechanism of injury, comorbidities, neurologic status, and surgical treatment was analyzed from a multicenter STSG observational database. Outcome measured included ASIA Motor Score, ASIA Grade, Functional Independence Measure (FIM) Score, SF-36, Sphincter Disturbance, and Ambulatory status. Measures were recorded on admission, discharge, 6 months and 1 year. At 12-month follow-up, early surgery resulted in a 6.31 point greater improvement in total motor score than did the late surgery group, with a P = 0.0358. At 6-month follow-up, early surgery result in higher chance of improvement in ASIA Grade than late surgery, with an odds ratio = 3.39, while at 12-month follow-up early surgery resulted in a higher chance of improvement in ASIA Grade, with an odds ratio of 2.81. Patients who were operated on within 24 hours had 7.79 U more improvement in FIM Total Score than late surgery at 6 month follow-up, with P = 0.0474. The consensus of experts following review of relevant and examination of observational dataset concluded that it is reasonable and safe to consider early surgical decompression in patients with profound neurologic deficit (ASIA = C) and persistent

  19. Inadequate peak expiratory flow meter characteristics detected by a computerised explosive decompression device

    DEFF Research Database (Denmark)

    Miller, M.R.; Atkins, P.R.; Pedersen, O.F.


    Methods: The dynamic response of mini-Wright (MW), Vitalograph (V), TruZone (TZ), MultiSpiro (MS) and pneumotachograph (PT) flow meters was tested by delivering two differently shaped flow-time profiles from a computer controlled explosive decompression device fitted with a fast response solenoid.......1) and 257 (39.2), respectively, and at ≈200 l/min they were 51 (23.9) and 1 (0.5). All the meters met ATS accuracy requirements when tested with their waveforms. Conclusions: An improved method for testing the dynamic response of flow meters detects marked overshoot (underdamping) of TZ and MS responses...

  20. Utilization of steam- and explosion-decompressed aspen wood by some anaerobes

    Energy Technology Data Exchange (ETDEWEB)

    Khan, A W; Asther, M; Giuliano, C


    Tests made to study the suitability of using steam- and explosion-decompressed aspen wood as a substrate in anaerobic fermentations indicated that after washing with dilute NaOH it becomes less than 80% accessible to both mesophilic and thermophilic cellulolytic anaerobes and cellulases, compared with delignified, ball-milled pulp. After washing, this material was also suitable for the single-step conversion of cellulose to EtOH using cocultures consisting of cellulolytic and EtOH-producing saccharolytic anaerobes; and without and after washing by the use of cellulolytic enzymes and ethanologenic anaerobes.

  1. Lumbar Radiculopathy in the Setting of Degenerative Scoliosis: MIS Decompression and Limited Correction are Better Options. (United States)

    Fontes, Ricardo B; Fessler, Richard G


    Surgery for adult spinal deformity (ASD) has emerged as an efficient treatment alternative, but it is fraught with potential perioperative morbidity, incompletely mitigated by emerging minimally invasive surgical techniques. In mild-to-moderate ASD balanced in the sagittal plane, there are situations in which the counterintuitive simple decompression through a foraminotomy or laminectomy, or even a short-segment fusion may be an attractive treatment. This article presents a case example and the authors' treatment rationale and reviews the limited available literature supporting it. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Sickness absence: a systematic review and meta-analysis of psychological treatments for individuals on sick leave due to common mental disorders. (United States)

    Salomonsson, Sigrid; Hedman-Lagerlöf, Erik; Öst, Lars-Göran


    Sick leave due to common mental disorders (CMDs) increase rapidly and present a major societal challenge. The overall effect of psychological interventions to reduce sick leave and symptoms has not been sufficiently investigated and there is a need for a systematic review and meta-analysis of the field. The aim of the present meta-analysis was to calculate the effect size of psychological interventions for CMDs on sick leave and psychiatric symptoms based on all published randomized controlled trials. Methodological quality, the risk of bias and publication bias were also assessed. The literature searches gave 2240 hits and 45 studies were included. The psychological interventions were more effective than care as usual on both reduced sick leave (g = 0.15) and symptoms (g = 0.21). There was no significant difference in effect between work focused interventions, problem-solving therapy, cognitive behavioural therapy or collaborative care. We conclude that psychological interventions are more effective than care as usual to reduce sick leave and symptoms but the effect sizes are small. More research is needed on psychological interventions that evaluate effects on sick leave. Consensual measures of sick leave should be established and quality of psychotherapy for patients on sick leave should be improved.

  3. Differences in predictors of return to work among long-term sick-listed employees with different self-reported reasons for sick leave

    NARCIS (Netherlands)

    Huijs, J.J.J.M.; Koppes, L.L.J.; Taris, T.W.; Blonk, R.W.B.


    Introduction The present study aimed to gain insight in the predictors of full return to work (RTW) among employees on long-term sick leave due to three different self-reported reasons for sick leave: physical, mental or comorbid physical and mental problems. This knowledge can be used to develop

  4. Common Mental Disorders in Longterm-Sickness Absence

    DEFF Research Database (Denmark)

    Søgaard, Hans Jørgen

    provided, in a randomized controlled design, a psychiatric examination giving feedback to the individuals, primary care, and rehabilitation officers with regard to treatment and rehabilitation. Half of individuals who just had passed eight weeks of continuous sickness absence had a mental disorder of which......Common Mental Disorders (CMD) such as depression, anxiety, and somatoform disorders impose heavy burdens on individuals and on society in the form of sickness absence. CMD are frequently undetected in primary care which postpone the initiation of proper treatment. This seriously worsens return...... to work (RTW). Comorbidity with somatic disorders also worsens RTW. CMD are, controlled for lifestyle, independent causes for the development of chronic and disabling somatic disorders. Collaborative care seems to be most effective intervention with regard to RTW. In this dissertation, the intervention...

  5. Mechanisms of selective attention and space motion sickness (United States)

    Kohl, R. L.


    The neural mismatch theory of space motion sickness asserts that the central and peripheral autonomic sequelae of discordant sensory input arise from central integrative processes falling to reconcile patterns of incoming sensory information with existing memory. Stated differently, perceived novelty reaches a stress level as integrative mechanisms fail to return a sense of control to the individual in the new environment. Based on evidence summarized here, the severity of the neural mismatch may be dependent upon the relative amount of attention selectively afforded to each sensory input competing for control of behavior. Components of the limbic system may play important roles in match-mismatch operations, be therapeutically modulated by antimotion sickness drugs, and be optimally positioned to control autonomic output.

  6. The effect of mild motion sickness and sopite syndrome on multitasking cognitive performance. (United States)

    Matsangas, Panagiotis; McCauley, Michael E; Becker, William


    In this study, we investigated the effects of mild motion sickness and sopite syndrome on multitasking cognitive performance. Despite knowledge on general motion sickness, little is known about the effect of motion sickness and sopite syndrome on multitasking cognitive performance. Specifically, there is a gap in existing knowledge in the gray area of mild motion sickness. Fifty-one healthy individuals performed a multitasking battery. Three independent groups of participants were exposed to two experimental sessions. Two groups received motion only in the first or the second session, whereas the control group did not receive motion. Measurements of motion sickness, sopite syndrome, alertness, and performance were collected during the experiment Only during the second session, motion sickness and sopite syndrome had a significant negative association with cognitive performance. Significant performance differences between symptomatic and asymptomatic participants in the second session were identified in composite (9.43%), memory (31.7%), and arithmetic (14.7%) task scores. The results suggest that performance retention between sessions was not affected by mild motion sickness. Multitasking cognitive performance declined even when motion sickness and soporific symptoms were mild. The results also show an order effect. We postulate that the differential effect of session on the association between symptomatology and multitasking performance may be related to the attentional resources allocated to performing the multiple tasks. Results suggest an inverse relationship between motion sickness effects on performance and the cognitive effort focused on performing a task. Even mild motion sickness has potential implications for multitasking operational performance.

  7. Interaction of Physical Exposures and Occupational Factors on Sickness Absence in Automotive Industry Workers. (United States)

    Valirad, Fateme; Ghaffari, Mostafa; Abdi, Alireza; Attarchi, Mirsaeed; Mircheraghi, Seyed Farzin; Mohammadi, Saber


    Increased sickness absence in recent years has been a trouble making issue in industrial society. Identify the causes of sickness absence and its influencing factors, is an important step to control and reduce its associated complications and costs. The aim of this study was to evaluate main factors associated with the incidence of sickness absence. In 2012, a cross-sectional study on 758 employees of a car accessories producing company was applied and relevant information about the number of days and episodes of sickness absence, Disease resulting in absence from work, personal features, occupational factors and physical exposures were collected. To determine risk factors associated with sickness absence, Logistic regression analysis was used. The most common diseases leading to sickness absence in order of frequency were Respiratory diseases, musculoskeletal disorders, gastrointestinal diseases and injuries at work. Musculoskeletal disorders increased the danger of long term absence by 4/33 times. Blue collar and shift works were the most important occupational factors associated with the incidence of sickness absence. The main physical factors that affect incidence of sickness absence were frequent bending-twisting and heavy lifting. Identifying controllable factors of sickness absence and trying to prevent and modify them such as compliance of ergonomic principals to decrease physical can be effective in reducing sickness absence.

  8. Cost-effectiveness of decompression according to Gill versus instrumented spondylodesis in the treatment of sciatica due to low grade spondylolytic spondylolisthesis: A prospective randomised controlled trial [NTR1300

    NARCIS (Netherlands)

    M.P. Arts (Mark); M.J.T. Verstegen (Marco); R. Brand (René); B.W. Koes (Bart); M.E. van den Akker-van Marle (Elske); W.C. Peul (Wilco)


    textabstractBackground. Nerve root decompression with instrumented spondylodesis is the most frequently performed surgical procedure in the treatment of patients with symptomatic low-grade spondylolytic spondylolisthesis. Nerve root decompression without instrumented fusion, i.e. Gill's procedure,

  9. Successful Left-Heart Decompression during Extracorporeal Membrane Oxygenation in an Adult Patient by Percutaneous Transaortic Catheter Venting

    Directory of Open Access Journals (Sweden)

    Tae Hee Hong


    Full Text Available Venoarterial extracorporeal membrane oxygenation (VA ECMO is widely used in patients with cardiogenic shock. Insufficient decompression of the left ventricle (LV is considered a major factor preventing adequate LV recovery. A 40-year-old male was diagnosed with acute myocardial infarction, and revascularization was performed using percutaneous stenting. However, cardiogenic shock occurred, and VA ECMO was initiated. Severe LV failure developed, and percutaneous transaortic catheter venting (TACV was incorporated into the venous circuit of VA ECMO under transthoracic echocardiography guidance. The patient was successfully weaned from VA ECMO. Percutaneous TACV is an effective, relatively noninvasive, and rapid method of LV decompression in patients undergoing VA ECMO.

  10. Absence from work and the medical sickness certificate. (United States)

    Massoni, F; Salesi, M; Sarra, M V; Ricci, S


    Internet and dematerialization have greatly facilitated the medical profession. Contractual physicians and national health service doctors now have efficient tools for the electronic management of their routine administrative workload. A recent innovation is the medical sickness certificate issued by primary care providers and national health service physicians. Following postponements and uncertainties, procedures for the electronic completion and online transmission of the sickness certificate are now complete. The changes introduced by the so-called "Brunetta decree", however, have made its application difficult and continuous improvement to the system is needed, considering also the severe penalties imposed for violations. In the light of serious legal repercussions for health care professionals, this article examines various critical issues, highlighting the pitfalls and the network's enormous potential for ascertaining evidence of irregularities. The overheated debate on absenteeism due to illness, the diverse roles of national health physicians and self-employed doctors responsible for issuing a sickness certificate, and problems related to circumstances in which a doctor operates, are the key topics in this discussion. Computerization is an effective tool for optimizing public resources; however, it also seeks to ferret out, through the traceability of certification, abuse of medical certification, with severe penalties applied if certificates are discovered to contain misleading or untrue information.

  11. Management of long term sickness absence: a systematic realist review. (United States)

    Higgins, Angela; O'Halloran, Peter; Porter, Sam


    The increasing impact and costs of long term sickness absence have been well documented. However, the diversity and complexity of interventions and of the contexts in which these take place makes a traditional review problematic. Therefore, we undertook a systematic realist review to identify the dominant programme theories underlying best practice, to assess the evidence for these theories, and to throw light on important enabling or disabling contextual factors. A search of the scholarly literature from 1950 to 2011 identified 5,576 articles, of which 269 formed the basis of the review. We found that the dominant programme theories in relation to effective management related to: early intervention or referral by employers; having proactive organisational procedures; good communication and cooperation between stakeholders; and workplace-based occupational rehabilitation. Significant contextual factors were identified as the level of support for interventions from top management, the size and structure of the organisation, the level of financial and organisational investment in the management of long-term sickness absence, and the quality of relationships between managers and staff. Consequently, those with responsibility for managing absence should bear in mind the contextual factors that are likely to have an impact on interventions, and do what they can to ensure stakeholders have at least a mutual understanding (if not a common purpose) in relation to their perceptions of interventions, goals, culture and practice in the management of long term sickness absence.

  12. [Disability leave and sick leave in Spain. 2016 legislative update]. (United States)

    Vicente-Herrero, María Teófila; Terradillos-García, María Jesús; Capdevila-García, Luisa M; Ramírez-Íñiguez de la Torre, María Victoria; Aguilar-Jiménez, Encarna; Aguado-Benedí, María José; López-González, Angel Arturo; Torres-Alberich, José Ignacio


    In Spanish, the concepts of discapacidad (disability leave) and incapacidad (sick leave) jointly refer to the impairment of a person due to injuries, diseases or deficiencies that limit their activity in a social, personal or occupational field. However, this common link does not imply that both concepts are the same. Statistical data from INE (Instituto Nacional de Estadística: Statistic National Institute) show that Spain had in 2015 3.85 million persons with a disability (59.8% were women). Statistical data from 2015 from INSS (Instituto Nacional de Seguridad Social: Social Security National Institute) show high levels in the number of processes and in workers affected by temporary sick leave, with social costs to the social security system. Both concepts have been updated: about disability leave, Law 39/2006 adjusted terminology by avoiding the use of concepts with discriminating or pejorative connotation. Regarding sick leave, the Ley General de Seguridad Social (General Social Security Law)has been amended and came into effect in January, 2016. It is necessary to know and distinguish these aspects for a better administrative management, and a more oriented information to the affected patient.

  13. Subjective Vertical Conflict Theory and Space Motion Sickness. (United States)

    Chen, Wei; Chao, Jian-Gang; Wang, Jin-Kun; Chen, Xue-Wen; Tan, Cheng


    Space motion sickness (SMS) remains a troublesome problem during spaceflight. The subjective vertical (SV) conflict theory postulates that all motion sickness provoking situations are characterized by a condition in which the SV sensed from gravity and visual and idiotropic cues differs from the expected vertical. This theory has been successfully used to predict motion sickness in different vehicles on Earth. We have summarized the most outstanding and recent studies on the illusions and characteristics associated with spatial disorientation and SMS during weightlessness, such as cognitive map and mental rotation, the visual reorientation and inversion illusions, and orientation preferences between visual scenes and the internal z-axis of the body. The relationships between the SV and the incidence of and susceptibility to SMS as well as spatial disorientation were addressed. A consistent framework was presented to understand and explain SMS characteristics in more detail on the basis of the SV conflict theory, which is expected to be more advantageous in SMS prediction, prevention, and training.


    Directory of Open Access Journals (Sweden)

    G.A. Samsygina


    Full Text Available Among the sickly children, pharyngitis and tonsillopharyngitis are quite often accompanied by pain and scratch in a throat, which is anguished for a child themselves and causes parents to worry. In the therapy for the indicated pathology, a certain place is held by a local antibiotic fusafungine. In the article, the author studies the effects of fusafungine on tonsillitis/tonsillopharyngitis and pharyngitis, running with pain in a throat, among the sickly children aged between 3 and 15. The research was carried on in 42 centers of different Russian regions and became a part of the multicentered research according to «Chibis» program. 2,609 children were examined, 1,907 of who Received fusafungine and 702 children did not. Among 78,1% of the children, the authors noted the phenomena of pharyngitis, rhinopharyngitis and acute tonsillopharyngitis. As the research showed the symptoms of rhinopharyngitis and tonsillopharync gitis were reliably arrested much faster, when applying fusafungine, thus, the clinical effects mostly emerged after 4th–5th day of the therapy. The acquired data allowed one to recommend the inclusion of fusafungine into the therapy for acute rhinopharyngitis, pharyngitis and tonsillopharyngitis among the sickly children.Key words: rhinopharyngitis, pharyngitis, tonsillopharyngitis, fusafungine, children, treatment.

  15. Dynamics of gas bubble growth in oil-refrigerant mixtures under isothermal decompression

    Energy Technology Data Exchange (ETDEWEB)

    Dias, Joao Paulo; Barbosa Junior, Jader R.; Prata, Alvaro T. [Federal University of Santa Catarina (UFSC), Florianopolis, SC (Brazil). Dept. of Mechanical Engineering], Emails:,,


    This paper proposes a numerical model to predict the growth of gaseous refrigerant bubbles in oil-refrigerant mixtures with high contents of oil subjected to isothermal decompression. The model considers an Elementary Cell (EC) in which a spherical bubble is surrounded by a concentric and spherical liquid layer containing a limited amount of dissolved liquid refrigerant. The pressure reduction in the EC generates a concentration gradient at the bubble interface and the refrigerant is transported to the bubble by molecular diffusion. After a sufficiently long period of time, the concentration gradient in the liquid layer and the bubble internal pressure reach equilibrium and the bubble stops growing, having attained its stable radius. The equations of momentum and chemical species conservation for the liquid layer, and the mass balance at the bubble interface are solved via a coupled finite difference procedure to determine the bubble internal pressure, the refrigerant radial concentration distribution and the bubble growth rate. Numerical results obtained for a mixture of ISO VG10 ester oil and refrigerant HFC-134a showed that bubble growth dynamics depends on model parameters like the initial bubble radius, initial refrigerant concentration in the liquid layer, decompression rate and EC temperature. Despite its simplicity, the model showed to be a potential tool to predict bubble growth and foaming which may result from important phenomena occurring inside refrigeration compressors such as lubrication of sliding parts and refrigerant degassing from the oil stored in oil sump during compressor start-up. (author)

  16. Microvascular decompression for the patient with painful tic convulsif after Bell palsy. (United States)

    Jiao, Wei; Zhong, Jun; Sun, Hui; Zhu, Jin; Zhou, Qiu-Meng; Yang, Xiao-Sheng; Li, Shi-Ting


    Painful tic convulsif is referred to as the concurrent trigeminal neuralgia and hemifacial spasm. However, painful tic convulsif after ipsilateral Bell palsy has never been reported before. We report a case of a 77-year-old woman with coexistent trigeminal neuralgia and hemifacial spasm who had experienced Bell palsy half a year ago. The patient underwent microvascular decompression. Intraoperatively, the vertebrobasilar artery was found to deviate to the symptomatic side and a severe adhesion was observed in the cerebellopontine angle. Meanwhile, an ectatic anterior inferior cerebellar artery and 2 branches of the superior cerebellar artery were identified to compress the caudal root entry zone (REZ) of the VII nerve and the rostroventral cisternal portion of the V nerve, respectively. Postoperatively, the symptoms of spasm ceased immediately and the pain disappeared within 3 months. In this article, the pathogenesis of the patient's illness was discussed and it was assumed that the adhesions developed from inflammatory reactions after Bell palsy and the anatomic features of the patient were the factors that generated the disorder. Microvascular decompression surgery is the suggested treatment of the disease, and the dissection should be started from the caudal cranial nerves while performing the operation.

  17. Spinal Epidural Hematoma after Thoracolumbar Posterior Fusion Surgery without Decompression for Thoracic Vertebral Fracture

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    Tsuyoki Minato


    Full Text Available We present a rare case of spinal epidural hematoma (SEH after thoracolumbar posterior fusion without decompression surgery for a thoracic vertebral fracture. A 42-year-old man was hospitalized for a thoracic vertebral fracture caused by being sandwiched against his back on broken concrete block. Computed tomography revealed a T12 dislocation fracture of AO type B2, multiple bilateral rib fractures, and a right hemopneumothorax. Four days after the injury, in order to promote early orthostasis and to improve respiratory status, we performed thoracolumbar posterior fusion surgery without decompression; the patient had back pain but no neurological deficits. Three hours after surgery, he complained of acute pain and severe weakness of his bilateral lower extremities; with allodynia below the level of his umbilicus, postoperative SEH was diagnosed. We performed immediate revision surgery. After removal of the hematoma, his symptoms improved gradually, and he was discharged ambulatory one month after revision surgery. Through experience of this case, we should strongly consider the possibility of preexisting SEH before surgery, even in patients with no neurological deficits. We should also consider perioperative coagulopathy in patients with multiple trauma, as in this case.

  18. Design of mulitlevel OLF approach ("V"-shaped decompressive laminoplasty) based on 3D printing technology. (United States)

    Ling, Qinjie; He, Erxing; Ouyang, Hanbin; Guo, Jing; Yin, Zhixun; Huang, Wenhua


    To introduce a new surgical approach to the multilevel ossification of the ligamentum flavum (OLF) aided by three-dimensional (3D) printing technology. A multilevel OLF patient (male, 66 years) was scanned using computed tomography (CT). His saved DICOM format data were inputted to the Mimics14.0 3D reconstruction software (Materialise, Belgium). The resulting 3D model was used to observe the anatomical features of the multilevel OLF area and to design the surgical approach. At the base of the spinous process, two channels were created using an osteotomy bilaterally to create a "V" shape to remove the bone ligamentous complex (BLC). The decompressive laminoplasty using mini-plate fixation was simulated with the computer. The physical model was manufactured using 3D printing technology. The patient was subsequently treated using the designed surgery. The operation was completed successfully without any complications. The operative time was 90 min, and blood loss was 200 ml. One month after the operation, neurologic function was recovered well, and the JOA score was improved from 6 preoperatively to 10. Postoperative CT scanning showed that the OLF was totally removed, and the replanted BLC had not subsided. 3D printing technology is an effective, reliable, and minimally invasive method to design operations. The technique can be an option for multilevel OLF surgical treatment. This can provide sufficient decompression with minimum damage to the spine and other intact anatomical structures.

  19. Magnetic resonance imaging criteria of successful core decompression in avascular necrosis of the hip

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    Radke, S.; Kirschner, S.; Seipel, V.; Rader, C.; Eulert, J. [Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, Julius-Maximilians University, Wuerzburg, Brettreichstr.11, 97074, Wuerzburg (Germany)


    To identify imaging criteria that determine the outcome of core decompression (CD) in femoral-head avascular necrosis (AVN). Radiographs and magnetic resonance imaging (MRI) of 65 hips with early stage AVN treated by core decompression between January 1990 and December 2000 for AVN were reviewed. All hips were categorized into two groups according to the result of CD using total hip arthroplasty (THA) as an end point. Hips that had no THA at follow-up were allocated to group I; those treated with a THA were allocated to group II. CD results were calculated for each group using THA as an end point. The parameters analyzed were the presence or absence of edema associated with the double-line sign on the preoperative MRI, the type of epiphyseal scar (ES) according to Jing, and the type of necrosis according to Mitchell. On follow-up, 45 hips had no THA (group I); 20 patients had a THA (group II). Patients with a radiographic crescent sign and those with edema associated with the double-line sign progressed to THA significantly more frequently. The extent of the necrosis had less discriminatory effect between the two groups. ES and necrotic tissue types had no prognostic value. In regard to the success of CD, it is important to differentiate on MRI between a double line sign plus bone marrow edema and a double-line sign only. (orig.)

  20. Continuous decompression with intramedullary nailing for the treatment of unicameral bone cysts. (United States)

    Masquijo, Julio Javier; Baroni, Eduardo; Miscione, Horacio


    To evaluate the efficacy of decompression of unicameral bone cysts (UBCs) of the long bones with intramedullary nailing and to compare responses to treatment according to location. We evaluated 48 consecutive patients treated between January 1988 and June 2000. Mean age was 10.3 years. Mean follow-up was 9.8 years. Evaluation was performed according to the radiographic criteria of Capanna. UBCs were located in the proximal humerus (n = 24), humeral shaft (n = 2), proximal femur (n = 19), distal tibia (n = 2) and fibula (n = 1). A total of 62.5% presented a pathological fracture. Successful results were observed in 89.5% (26 total healing, 17 healing with residual radiolucent areas), and there were four recurrences and, in one case, no response to treatment. There was more healing in the humerus than in the femur (92.3% versus 84.2%), and more tendency to restitution ad integrum, although the difference was not statistically significant (P = 0.1499). Intramedullary nailing is a minimally invasive method, which permits early stability and decompresses the cyst allowing healing. Significant differences were not observed among results from different locations.