BACKGROUND Occupational hand and wrist injuries(OHWIs)account for 25%of work-related accidents in low-and middle-income countries.In Colombia,more than 500000 occupational accidents occurred in 2021,and although the r...BACKGROUND Occupational hand and wrist injuries(OHWIs)account for 25%of work-related accidents in low-and middle-income countries.In Colombia,more than 500000 occupational accidents occurred in 2021,and although the rate declined to less than 5%in 2020 and 2021,at least one in four accidents involved a hand or wrist injury.AIM To describe the OHWIs in workers seen at the emergency room at a second-level hospital in Colombia.METHODS An observational study was performed using data from workers who experienced OHWIs and attended a second-level hospital,between June,2020 and May,2021.The overall frequency of OHWIs,as well as their distribution by sociodemo-graphic,clinical,and occupational variables,are described.Furthermore,association patterns between sex,anatomical area(fingers,hand,wrist),and type of job were analyzed by correspondence analysis(CA).RESULTS There were 2.101 workers treated for occupational accidents,423(20.3%)were cases of OHWIs,which mainly affected men(93.9%)with a median age of 31 years and who worked mainly in mining(75.9%).OHWIs were more common in the right upper extremity(55.3%)and comprised different types of injuries,such as contusion(42.1%),laceration(27.9%),fracture(18.7%),and crush injury(15.6%).They primarily affected the phalanges(95.2%),especially those of the first finger(25.7%).The CAs showed associations between the injured anatomical area and the worker’s job that differed in men and women(explained variance>90%).CONCLUSION One out of five workers who suffered occupational accidents in Cundinamarca,Columbia had an OHWI,affecting mainly males employed in mining.This occupational profile is likely to lead to prolonged rehabilitation,and permanent functional limitations.Our results might be useful for adjusting preventive measures in cluster risk groups.展开更多
AIM To provide suggestions for hand injury prevention by study the demography and risk factors of casualties suffering from isolated hand injuries.METHODS All trauma patients with isolated hand injuries who were admit...AIM To provide suggestions for hand injury prevention by study the demography and risk factors of casualties suffering from isolated hand injuries.METHODS All trauma patients with isolated hand injuries who were admitted to Al Ain Hospital for more than 24 h during a period of 3 years were studied. Patient demographics,location, mechanism/time of injury, and length of hospital stay were all analyzed.RESULTS Two hundred and ten patients were studied. Their mean age was 29.7 years. Males constituted 92%. Sixty-five point one percent of all cases were from the Indian subcontinent. The workplace was the most common location of injury(67.1%), followed by the home(17.1%)and road(6.2%). Machinery caused 36.2% of all injuries,followed by heavy object(20.5%) and fall(11%). Cases injured at home were young(P < 0.0001) with an associated higher incidence of females(P < 0.0001).CONCLUSION Male workers in Al Ain city are at greater risk of sustaining hand injuries, predominantly from machinery. Safety education, personal protection, and the enforcement of safety standards are essential to the prevention and avoidance of hand injury.展开更多
Aims & Objectives: To study the epidemiology of workplace hand injuries, to understand relation between mode of injury and prognosis, to investigate into the possible contributing factors and to study the Socio-ec...Aims & Objectives: To study the epidemiology of workplace hand injuries, to understand relation between mode of injury and prognosis, to investigate into the possible contributing factors and to study the Socio-economic impact. Design of Study: For the prospective study there were 2 sources of data: 1) Proforma which was filled by the hand surgeon and 2) A questionnaire that was filled up by safety officer. For the retrospective study case, sheets were retrieved from the Medical Records section and a telephonic or personal interview was carried out by a single interviewer. Setting: Department of Plastic and Reconstructive Surgery, Parvathy Hospital, Chennai, India. Patients: A total of 419 industrial injury patients treated from January 2008 to January 2013 were included in the study. Further follow-up regarding return to work and residual disability continues. Main Outcome Measures: Personal details (Age, Gender, Handedness, Work experience, Income). Type of injury, mode of injury, day and time of injury, treatment given, disability and number of working days lost were measured. Results: Those workers who were experienced less than 6 months had more workplace injuries and the commonest contributing factor was co-workers carelessness followed by long working hours and faulty machinery. Maximum injuries occurred on Monday and morning shift. Conclusions: Constant supervision of trainees for 2 years, shorter working hours with regular breaks, regular health checkups for personnel, regular servicing of machines can prevent occurrence of hand injuries. Corrective surgery within 6 hours, systematic and protocol based physiotherapy and rehabilitation can reduce the economic loss and disability arising out of work place injuries.展开更多
Traffic intersections are incredibly dangerous for drivers and pedestrians. Statistics from both Canada and the U.S. show a high number of fatalities and serious injuries related to crashes at intersections. In Canada...Traffic intersections are incredibly dangerous for drivers and pedestrians. Statistics from both Canada and the U.S. show a high number of fatalities and serious injuries related to crashes at intersections. In Canada, during 2019, the National Collision Database shows that 28% of traffic fatalities and 42% of serious injuries occurred at intersections. Likewise, the U.S. National Highway Traffic Administration (NHTSA) found that about 40% of the estimated 5,811,000 accidents in the U.S. during the year studied were intersection-related crashes. In fact, a major survey by the car insurance industry found that nearly 85% of drivers could not identify the correct action to take when approaching a yellow traffic light at an intersection. One major reason for these accidents is the “yellow light dilemma,” the ambiguous situation where a driver should stop or proceed forward when unexpectedly faced with a yellow light. This situation is even further exacerbated by the tendency of aggressive drivers to inappropriately speed up on the yellow just to get through the traffic light. A survey of Canadian drivers conducted by the Traffic Injury Research Foundation found that 9% of drivers admitted to speeding up to get through a traffic light. Another reason for these accidents is the increased danger of making a left-hand turn on yellow. According to the National Highway Traffic Safety Association (NHTSA), left turns occur in approximately 22.2% of collisions—as opposed to just 1.2% for right turns. Moreover, a study by CNN found left turns are three times as likely to kill pedestrians than right turns. The reason left turns are so much more likely to cause an accident is because they take a driver against traffic and in the path of oncoming cars. Additionally, most of these left turns occur at the driver’s discretion—as opposed to the distressingly brief left-hand arrow at busy intersections. Drive Safe Now proposes a workable solution for reducing the number of accidents occurring during a yellow light at intersections. We believe this fairly simple solution will save lives, prevent injuries, reduce damage to public and private property, and decrease insurance costs.展开更多
A rat model of middle cerebral artery permanent occlusion was established using the modified Longa method. Successfully established model animals were treated by blood-letting puncture at twelve Jing-Well points of th...A rat model of middle cerebral artery permanent occlusion was established using the modified Longa method. Successfully established model animals were treated by blood-letting puncture at twelve Jing-Well points of the hand, and/or by injecting mannitol into the caudal vein twice daily. Brain tissue was collected at 24, 48 and 72 hours after modeling, and blood was collected through the retinal vein before Evans blue was injected, approximately 1 hour prior to harvesting of brain tissue. Results showed that Evans blue leakage into brain tissue and serum nitric oxide synthase activity were significantly increased in model rats. Treatment with blood-letting punctures at twelve Jing-Well points of the hand and/or injection of mannitol into the caudal vein reduced the amount of Evans blue leakage into the brain tissue and serum nitric oxide synthase activity to varying degrees. There was no significant difference between single treatment and combined treatment. Experimental findings indicate that blood-letting punctures at twelve Jing-Well points of the hand can decrease blood-brain barrier permeability and serum nitric oxide synthase activity in rats following middle cerebral artery occlusion, and its effect is similar to that of mannitol injection alone and Jing-Well points plus mannitol injection.展开更多
BACKGROUND: This prospective observational study aimed to determine the infection rate of simple hand laceration(SHL), and to compare infection rates between patients who were prescribed antibiotics and those who were...BACKGROUND: This prospective observational study aimed to determine the infection rate of simple hand laceration(SHL), and to compare infection rates between patients who were prescribed antibiotics and those who were not.METHODS: The study was performed at two urban hospitals enrolling 125 emergency department(ED) patients with SHL. Exclusion criteria included patients with lacerations for more than 12 hours, immunocompromized patients, patients given antibiotics, and patients with gross contamination, bites or crush injuries. Wound infection was defined as clinical infection at a follow-up visit(10–14 days) or wound was treated with antibiotics. Patient satisfaction was also measured using a visual analogue scale 1–10, asking the patients about wound appearance. Demographic data and wound characteristics were compared between the infected and non-infected wounds. The infection rates were also compared between patients who received prophylactic antibiotics and those who did not. The results were presented with medians and quartiles or percentages with 95% confidence intervals(CI).RESULTS: In the 125 patients with SHL [median age: 28(18, 43); range: 1–102 years old; 36% female], 44(35%, 95% CI: 27%–44%) were given antibiotics in the ED. Wound infection was reported in 6 patients(4.8%, 95% CI: 2%–10%). Age, gender, history of diabetes and wound closure were not associated with wound infection(P>0.05). The infection rate was not significantly different between patients with or without antibiotic prophylaxis [7%(3/44), 95% CI: 2%–10% vs. 4%(3/81), 95% CI: 1%–11%, P=0.66]. Patient's satisfaction with appearance ofinfected and non-infected wounds were significantly different [7.5(6, 8) vs. 9(8, 10), P=0.01].CONCLUSION: Approximately 5% of simple hand lacerations become infected. Age, gender, diabetes, prophylactic antibiotics and closure technique do not affect the risk ofinfection.展开更多
BACKGROUND The nature of tasks required by hand surgeons require both forceful and repetitive maneuvers,thus subjecting these surgeons to the risk of musculoskeletal(MSK)injuries during their years in practice.AIM To ...BACKGROUND The nature of tasks required by hand surgeons require both forceful and repetitive maneuvers,thus subjecting these surgeons to the risk of musculoskeletal(MSK)injuries during their years in practice.AIM To assess the prevalence,characteristics and impact of MSK disorders among hand surgeons.METHODS A modified version of the physical discomfort survey was sent to surgeons who were members of the American Society for Surgery of the Hand via e-mail.The collected data were analyzed using descriptive statistics,one-way analysis of variance,and Fisher’s exact test.P values of<0.05 were considered statistically significant.RESULTS Of the 578 respondents,60.4%reported that they had sustained a work-related MSK injury,of which the most common diagnoses were lateral elbow epicondylitis(18.7%),low back pain(17.1%)and carpal tunnel syndrome(15.6%).Among those that reported an injury,73.1%required treatment and 29.2%needed time off work as a direct result of their injury.The number of work-related injuries incurred by a surgeon increased significantly with increasing age(P<0.003),increasing years in practice(P<0.001)and higher case load(P<0.05).CONCLUSION To our knowledge this study is the first of its kind to assess MSK injuries sustained by Hand surgeons with a high incidence.These results should increase awareness on this aspect and fuel future studies directed at preventing these types of work-related injuries,thus minimizing the financial and psychological burden on these surgeons and the healthcare system.展开更多
文摘BACKGROUND Occupational hand and wrist injuries(OHWIs)account for 25%of work-related accidents in low-and middle-income countries.In Colombia,more than 500000 occupational accidents occurred in 2021,and although the rate declined to less than 5%in 2020 and 2021,at least one in four accidents involved a hand or wrist injury.AIM To describe the OHWIs in workers seen at the emergency room at a second-level hospital in Colombia.METHODS An observational study was performed using data from workers who experienced OHWIs and attended a second-level hospital,between June,2020 and May,2021.The overall frequency of OHWIs,as well as their distribution by sociodemo-graphic,clinical,and occupational variables,are described.Furthermore,association patterns between sex,anatomical area(fingers,hand,wrist),and type of job were analyzed by correspondence analysis(CA).RESULTS There were 2.101 workers treated for occupational accidents,423(20.3%)were cases of OHWIs,which mainly affected men(93.9%)with a median age of 31 years and who worked mainly in mining(75.9%).OHWIs were more common in the right upper extremity(55.3%)and comprised different types of injuries,such as contusion(42.1%),laceration(27.9%),fracture(18.7%),and crush injury(15.6%).They primarily affected the phalanges(95.2%),especially those of the first finger(25.7%).The CAs showed associations between the injured anatomical area and the worker’s job that differed in men and women(explained variance>90%).CONCLUSION One out of five workers who suffered occupational accidents in Cundinamarca,Columbia had an OHWI,affecting mainly males employed in mining.This occupational profile is likely to lead to prolonged rehabilitation,and permanent functional limitations.Our results might be useful for adjusting preventive measures in cluster risk groups.
基金Supported by An Interdisciplinary UAE University grant,No.02-07-8-1/4
文摘AIM To provide suggestions for hand injury prevention by study the demography and risk factors of casualties suffering from isolated hand injuries.METHODS All trauma patients with isolated hand injuries who were admitted to Al Ain Hospital for more than 24 h during a period of 3 years were studied. Patient demographics,location, mechanism/time of injury, and length of hospital stay were all analyzed.RESULTS Two hundred and ten patients were studied. Their mean age was 29.7 years. Males constituted 92%. Sixty-five point one percent of all cases were from the Indian subcontinent. The workplace was the most common location of injury(67.1%), followed by the home(17.1%)and road(6.2%). Machinery caused 36.2% of all injuries,followed by heavy object(20.5%) and fall(11%). Cases injured at home were young(P < 0.0001) with an associated higher incidence of females(P < 0.0001).CONCLUSION Male workers in Al Ain city are at greater risk of sustaining hand injuries, predominantly from machinery. Safety education, personal protection, and the enforcement of safety standards are essential to the prevention and avoidance of hand injury.
文摘Aims & Objectives: To study the epidemiology of workplace hand injuries, to understand relation between mode of injury and prognosis, to investigate into the possible contributing factors and to study the Socio-economic impact. Design of Study: For the prospective study there were 2 sources of data: 1) Proforma which was filled by the hand surgeon and 2) A questionnaire that was filled up by safety officer. For the retrospective study case, sheets were retrieved from the Medical Records section and a telephonic or personal interview was carried out by a single interviewer. Setting: Department of Plastic and Reconstructive Surgery, Parvathy Hospital, Chennai, India. Patients: A total of 419 industrial injury patients treated from January 2008 to January 2013 were included in the study. Further follow-up regarding return to work and residual disability continues. Main Outcome Measures: Personal details (Age, Gender, Handedness, Work experience, Income). Type of injury, mode of injury, day and time of injury, treatment given, disability and number of working days lost were measured. Results: Those workers who were experienced less than 6 months had more workplace injuries and the commonest contributing factor was co-workers carelessness followed by long working hours and faulty machinery. Maximum injuries occurred on Monday and morning shift. Conclusions: Constant supervision of trainees for 2 years, shorter working hours with regular breaks, regular health checkups for personnel, regular servicing of machines can prevent occurrence of hand injuries. Corrective surgery within 6 hours, systematic and protocol based physiotherapy and rehabilitation can reduce the economic loss and disability arising out of work place injuries.
文摘Traffic intersections are incredibly dangerous for drivers and pedestrians. Statistics from both Canada and the U.S. show a high number of fatalities and serious injuries related to crashes at intersections. In Canada, during 2019, the National Collision Database shows that 28% of traffic fatalities and 42% of serious injuries occurred at intersections. Likewise, the U.S. National Highway Traffic Administration (NHTSA) found that about 40% of the estimated 5,811,000 accidents in the U.S. during the year studied were intersection-related crashes. In fact, a major survey by the car insurance industry found that nearly 85% of drivers could not identify the correct action to take when approaching a yellow traffic light at an intersection. One major reason for these accidents is the “yellow light dilemma,” the ambiguous situation where a driver should stop or proceed forward when unexpectedly faced with a yellow light. This situation is even further exacerbated by the tendency of aggressive drivers to inappropriately speed up on the yellow just to get through the traffic light. A survey of Canadian drivers conducted by the Traffic Injury Research Foundation found that 9% of drivers admitted to speeding up to get through a traffic light. Another reason for these accidents is the increased danger of making a left-hand turn on yellow. According to the National Highway Traffic Safety Association (NHTSA), left turns occur in approximately 22.2% of collisions—as opposed to just 1.2% for right turns. Moreover, a study by CNN found left turns are three times as likely to kill pedestrians than right turns. The reason left turns are so much more likely to cause an accident is because they take a driver against traffic and in the path of oncoming cars. Additionally, most of these left turns occur at the driver’s discretion—as opposed to the distressingly brief left-hand arrow at busy intersections. Drive Safe Now proposes a workable solution for reducing the number of accidents occurring during a yellow light at intersections. We believe this fairly simple solution will save lives, prevent injuries, reduce damage to public and private property, and decrease insurance costs.
基金sponsored by the Open Research Fund of Zhejiang First-foremost Key Subject-Acupuncture & Moxibustion,No. ZTK2010A07
文摘A rat model of middle cerebral artery permanent occlusion was established using the modified Longa method. Successfully established model animals were treated by blood-letting puncture at twelve Jing-Well points of the hand, and/or by injecting mannitol into the caudal vein twice daily. Brain tissue was collected at 24, 48 and 72 hours after modeling, and blood was collected through the retinal vein before Evans blue was injected, approximately 1 hour prior to harvesting of brain tissue. Results showed that Evans blue leakage into brain tissue and serum nitric oxide synthase activity were significantly increased in model rats. Treatment with blood-letting punctures at twelve Jing-Well points of the hand and/or injection of mannitol into the caudal vein reduced the amount of Evans blue leakage into the brain tissue and serum nitric oxide synthase activity to varying degrees. There was no significant difference between single treatment and combined treatment. Experimental findings indicate that blood-letting punctures at twelve Jing-Well points of the hand can decrease blood-brain barrier permeability and serum nitric oxide synthase activity in rats following middle cerebral artery occlusion, and its effect is similar to that of mannitol injection alone and Jing-Well points plus mannitol injection.
基金in part was funded by a medical student grant($2500)by the Emergency Medicine Foundation
文摘BACKGROUND: This prospective observational study aimed to determine the infection rate of simple hand laceration(SHL), and to compare infection rates between patients who were prescribed antibiotics and those who were not.METHODS: The study was performed at two urban hospitals enrolling 125 emergency department(ED) patients with SHL. Exclusion criteria included patients with lacerations for more than 12 hours, immunocompromized patients, patients given antibiotics, and patients with gross contamination, bites or crush injuries. Wound infection was defined as clinical infection at a follow-up visit(10–14 days) or wound was treated with antibiotics. Patient satisfaction was also measured using a visual analogue scale 1–10, asking the patients about wound appearance. Demographic data and wound characteristics were compared between the infected and non-infected wounds. The infection rates were also compared between patients who received prophylactic antibiotics and those who did not. The results were presented with medians and quartiles or percentages with 95% confidence intervals(CI).RESULTS: In the 125 patients with SHL [median age: 28(18, 43); range: 1–102 years old; 36% female], 44(35%, 95% CI: 27%–44%) were given antibiotics in the ED. Wound infection was reported in 6 patients(4.8%, 95% CI: 2%–10%). Age, gender, history of diabetes and wound closure were not associated with wound infection(P>0.05). The infection rate was not significantly different between patients with or without antibiotic prophylaxis [7%(3/44), 95% CI: 2%–10% vs. 4%(3/81), 95% CI: 1%–11%, P=0.66]. Patient's satisfaction with appearance ofinfected and non-infected wounds were significantly different [7.5(6, 8) vs. 9(8, 10), P=0.01].CONCLUSION: Approximately 5% of simple hand lacerations become infected. Age, gender, diabetes, prophylactic antibiotics and closure technique do not affect the risk ofinfection.
文摘BACKGROUND The nature of tasks required by hand surgeons require both forceful and repetitive maneuvers,thus subjecting these surgeons to the risk of musculoskeletal(MSK)injuries during their years in practice.AIM To assess the prevalence,characteristics and impact of MSK disorders among hand surgeons.METHODS A modified version of the physical discomfort survey was sent to surgeons who were members of the American Society for Surgery of the Hand via e-mail.The collected data were analyzed using descriptive statistics,one-way analysis of variance,and Fisher’s exact test.P values of<0.05 were considered statistically significant.RESULTS Of the 578 respondents,60.4%reported that they had sustained a work-related MSK injury,of which the most common diagnoses were lateral elbow epicondylitis(18.7%),low back pain(17.1%)and carpal tunnel syndrome(15.6%).Among those that reported an injury,73.1%required treatment and 29.2%needed time off work as a direct result of their injury.The number of work-related injuries incurred by a surgeon increased significantly with increasing age(P<0.003),increasing years in practice(P<0.001)and higher case load(P<0.05).CONCLUSION To our knowledge this study is the first of its kind to assess MSK injuries sustained by Hand surgeons with a high incidence.These results should increase awareness on this aspect and fuel future studies directed at preventing these types of work-related injuries,thus minimizing the financial and psychological burden on these surgeons and the healthcare system.
