Association of overtime work and obesity with needle stick and sharp injuries in medical practice

BACKGROUND Needle stick and sharps injuries(NSIs)may cause infections among medical personnel.Obesity and overtime work among medical personnel increase the incidence of work injuries.AIM To investigate whether overtime work and obesity increase the risk of NSIs.METHODS This cross-sectional study used the data of 847 hospital personnel,including 104 doctors,613 nurses,67 medical laboratory scientists,54 specialist technicians,and nine surgical assistants.Of them,29 participants notified the hospital of having at least one NSI in 2017.The data collected included age,overtime work,body mass index,medical specialty such as doctor or nurse,and professional grade such as attending physician or resident.Theχ2 and Fisher’s exact tests were used to compare categorical variables.Multiple logistic regression analysis and the Sobel test were used to assess the risk of NSIs.RESULTS Overtime work,body weight,and medical specialty were significantly associated with NSIs(P<0.05).After adjustment for risk factors,heavy overtime work was an independent risk factor for NSIs,and healthy body weight and nursing specialty were independent protective factors against NSIs.After adjustment for risk factors,medical personnel with healthy body weight has half as many NSIs as those with unhealthy body weight;the proportion of NSIs in doctors with healthy body weight was 0.2 times that in doctors with unhealthy body weight;the proportion of injuries among residents was 17.3 times higher than that among attending physicians;the proportion of injuries among junior nurses was 3.9 times higher than that among experienced nurses;the proportion of injuries among nurses with heavy overtime work was 6.6 times higher than that among nurses with mild overtime work;and the proportion of injuries among residents was 19.5 times higher than that among junior nurses.Heavy overtime work mediated the association of medical specialty with NSIs.CONCLUSION In addition to promoting the use of safety needles and providing infection control education,managers should review overtime schedules,and medical personnel should be encouraged to maintain a healthy weight.

芒针恢刺治疗髂胫束摩擦综合征-随机临床试验

Objective:to observe the clinical effect of acupuncture by mángzhen huid(relaxing needling with sharp long needle) on iliotibial band friction syndrome(ITBS).Design:this was a two-arm randomized controlled trial with blinding of participants,outcome assessment and statistician.Setting:acupuncture-Moxibustion,Tuina and Orthopedics Department and the Orthopedics Department of Shanghai the Sixth People’s Hospital,June 2018 to January 2021.Participants:a total of 64 patients with iliotibial band friction syndrome(ITBS).Interventions:with a 1:1 ratio the patients were randomly assigned to either the conventional acupuncture group(CA,n=32) or the Relaxing Needling with Sharp Long Needle group(RNSLN,n=32).The CA group was treated by applying acupuncture at Jūliáo(居髎GB 29),Fēngshì(风市GB 31),Liángqiū(梁丘ST34),Yánglingquán(阳陵泉GB 34),and Ashi points(阿是穴)of the affected side,and the RNSLN group was treated by applying relaxing needling with sharp long needle at GB 29,ST 34,and Ashi points of the affected side.Both groups were treated once every other day,10 times as one course of treatment.Outcome measures:the treatment effect was evaluated after one course of treatment by comparing their KSS scores and VAS scores,as well as overall response rate.Results:Sixty-four patients were included in the final data analysis.There was no difference in KSS and VAS scores between the two groups before treatment(P>0.05).After treatment,the KSS score of the two groups was higher than that before treatment,the VAS score of the two groups was lower than that before treatment(P<0.05).The KSS score of the RNSLN group was higher than that of the CA group,and the VAS score of the RNSLN group was lower than that of the CA group(P<0.05).The overall response rate of the RNSLN group was 93.75%,higher than 75% of the control group(P<0.05).Each group has 1case of subcutaneous bleeding as adverse event.Conclusion:Relaxing Needling with Sharp Long Needle could be more beneficial for iliotibial band friction syndrome(ITBS) compared with conventional acupuncture,and more evidence is required for its effectiveness before introducing the approach widely to clinical practice.

Differential fat harvesting

Aim:Volume replacement with fi llers is regularly performed with the use of diverse volumetric materials to correct different structures around the face,depending on the volume enhancement required and the thickness of the soft tissue envelope.Differential fat harvesting and posterior grafting is performed to place the correct fat parcel size for each target area,expanding the potential applications of fat.Methods:Sixty patients consecutively recruited on a fi rst come basis undergone a facial fat grafting procedure,in private practice setting between March 2012 and October 2013.Fat grafting quantity and quality was predicted for each case.Differential harvesting was performed,with 2 fat parcels size.Processing was performed through washing.Fat infi ltration was carried out through small cannulas or needles depending on the treated area.Outcomes were analysed both by the physicians and the patients at 7 days,1 month,3 months and 6 months through a perceived satisfaction questionnaire.Parameters considered were downtime or discomfort,skin benefi ts,volume restoration,reabsorption rate estimated and overall improvement.Results:Full facial differential fat grafting procedure lasted an average of 1.5-2.5 h.Average downtime was 3-4 days.Follow-up was performed to a minimum of 6 months.Both patient and physician overall satisfaction rates were mostly excellent.Adverse events like lumps or irregularities were not encountered.Conclusion:Differential fat harvesting and posterior grafting is a valid alternative,to expand the repertoire of fat use,allow a more homogeneous effect,reduce the potential complications,speed up the process,improve graft survival,and to enhance overall aesthetic outcome.