miércoles, 31 de octubre de 2012

CDC - NIOSH Science Blog – Joint Pain in the Workplace

CDC - NIOSH Science Blog – Joint Pain in the Workplace

Joint Pain in the Workplace

Musculoskeletal disorders (MSDs) include a number of physical conditions affecting muscles, tendons, nerves, ligaments, joints, and other soft tissues that can be caused, or exacerbated, by work.  It is estimated that MSDs account for approximately one-third of injury and illness costs in U.S. industry.  Many musculoskeletal conditions can result specifically in chronic or short-term joint pain.  One example of joint pain is arthritis, which is the leading cause of work disability, according to the CDC.  Arthritis is a condition in which the cartilage surfaces between bones wears away resulting in bone rubbing on bone.  In 2007, the annual cost of arthritis and other rheumatic conditions was reported to be $128 billion (MMWR, 2007).  This total included an estimated $47 billion in lost earnings.  The prevalence of arthritis in the U.S. is projected to increase to nearly 67 million (25% of the adult population) by the year 2030 with 25 million (9.3% of the adult population) projected to be limited in their physical activity because of the condition (Hootman and Helmick, 2006).  Working-age adults (45-64 years) will account for almost one-third of arthritis cases.  Workplace programs in the areas of safety, ergonomics, wellness, and disability management can all play a role in preventing joint pain and preserving joint health in working individuals of all ages.
Aging is a natural process that encompasses biological changes that tend to be associated with the development of joint pain or that may limit the ability to work with joint pain.  In addition to arthritic joint degeneration, aging is associated with loss of muscle mass and muscle function.  Functional loss is influenced by changes at the cellular and molecular physiology level.  These changes may reduce joint stability and impair normal joint motion that affect the ability to tolerate specific work postures and repetitive motion.  With a loss in muscle strength, the same level of physical effort places a greater demand on an individual relative to her/his capabilities.
The relationship between aging and joint pain in the workplace is complex and influenced by a number of factors.  For example, national surveys of workers across a wide variety of occupations indicate that not all older workers (50 years and older) report a greater risk of joint pain.  Older workers at greatest risk tend to be in jobs that have high physical demands.  And once an MSD has occurred, it may take longer for an older worker to return to work.  In spite of these factors, studies indicate that older workers suffer no decrease in overall job performance.
While chronological age can’t be slowed, evidence suggests ways in which the development of joint pain, or its effects, can be reduced through intervention.  Lifestyle interventions target individual factors that positively affect musculoskeletal health.  For instance, obesity has been shown to be a predictor of osteoarthritis (MMWR, 2010), suggesting a transference of benefits from obesity prevention to the prevention of joint pain.   Exercise, more specifically resistance training, has been shown to slow, or even reverse, the effects of aging (Melov et al. 2007)  and has been suggested to be possibly the most effective mode of exercise for improving quality of life as we age (Hartman et al., 2007).  One of the benefits of a well-designed exercise training program may be improved joint health.  Employers, like Lincoln Industries, are endorsing workplace exercise programs, in which employees participate at work sometimes even during work hours, as a preventive approach to preventing joint pain and musculoskeletal discomfort (see examples in Promising Practices for Total Worker HealthTM).
Lifestyle and wellness program interventions are important, but alone do not fully address the scope of joint pain and its prevalence in an aging workforce.  Workplaces can play an essential role in preserving joint health. To prevent MSDs and joint pain among employees, employers should emphasize workplace equipment and tools that reduce forces, repetition, vibration, and awkward work postures in physically demanding workplaces. Reducing these physical stresses in occupations is paramount to the prevention of joint pain and compliment individual wellness interventions.  These interventions often accommodate the employee with existing joint pain by reducing physical demands and allowing the affected individual to work productively.  In many cases, workplace modifications to achieve these affects are not costly capital investments.  Prevention of a single episode of joint injury is often sufficient for recovery of the cost of the intervention.
Emerging evidence suggests negative health consequences of sedentary work (van Uffelen et al., 2010).  This is an interesting contrast in that it gives rise to the redesign of office workplaces to increase overall activity level of the worker (see blog: VHA’s Success with Increasing Movement at Work). Sit/stand workstations have long been endorsed as a human factors solution to problems with seated work.  Standing computer workstations are gaining in popularity but are of unproven benefit as prolonged standing has associated health concerns.  Other socio-technical solutions have been proposed to integrate lower levels of dynamic activity into traditionally sedentary work in the form of treadmill workstations, accessible indoor walking trails and the use of these to encourage “walking meetings”. 
We are interested in hearing about your experience in the prevention and management of joint pain in the workplace.  What programs or activities does your organization have in place to prevent and/or reduce the burden of joint pain?  What should NIOSH be doing in this area?
Brian D. Lowe, PhD, CPE; Brent A. Baker, PhD, ATC; Jim Grosch, PhD, MBA
Dr. Lowe is a Research Industrial Engineer and Certified Professional Ergonomist with the Human Factors and Ergonomics Research Team in the NIOSH Division of Applied Research and Technology. 
Dr. Baker  is an Integrative Exercise Physiologist, Board Certified Athletic Trainer, and is Team Leader for the Musculoskeletal Pathomechanics Research Team in the NIOSH Health Effects Labortary Division.  
Dr. Grosch is a Senior Research Psychologist with the Work Organization and Stress Research Team in the Division of Applied Research and Technology.
Hartman MJ, Fields DA, Byrne MM, Hunter GR. 2007 Resistance Training Improves Metabolic Economy During Functional Tasks in Older Adults. JSCR 21(1): 91-95.
Hootman JM, Helmick CG. 2006 Projections of US prevalence of arthritis and associated activity limitations.  Arthritis Rheum. Jan;54(1):226-9.
Melov S, Tarnopolsky MA, Beckman K, Felkey K, Hubbard A. 2007 Resistance Exercise Reverses Aging in Human Skeletal Muscle. PLoS ONE 2(5): e465.
Morbidity and Mortality Weekly Report (MMWR)   National and State Medical Expenditure and Lost Earnings Attributable to Arthritis and Other Rheumatic Conditions – United States, 2003.  January 12, 2007/56(01); 4-7.
Morbidity and Mortality Weekly Report (MMWR)   Prevalence of Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation — United States, 2007—2009.   October 8, 2010 / 59(39);1261-1265
van Uffelen, J.G.Z. et al. (2010).  Occupational Sitting and Health Risks: A Systematic Review.   American journal of preventive medicine, 39 (4), 379-388.

Indoor Tanning: The Risks of Ultraviolet Rays (Consumer Update)

Indoor Tanning: The Risks of Ultraviolet Rays (Consumer Update)

Indoor Tanning: The Risk of Ultraviolet Radiation (video)

icon of a document Read this article
Sunlamps and tanning beds promise consumers a bronzed body year-round, but the ultraviolet (UV) radiation from these devices poses serious health risks. In this Consumer Update video, Sharon Miller, M.S.E.E., an FDA scientist and international expert on UV radiation, explains why it's important to avoid exposure to UV radiation from devices such as tanning beds, tanning booths, and portable home tanning units.

Date Posted: May 24, 2010

Related Consumer Updates

SAVE THE DATE : 13ème Marche des Maladies Rares à Paris

SAVE THE DATE : 13ème Marche des Maladies Rares à Paris


Check out the latest news and events from our members
13th March for Rare Diseases, December 8th, 2012, Paris. Organised by the Alliance Maladies Rares. More information: www.alliance-maladies-rares.org

Latest orphan designations and/or marketing authorisations | www.eurordis.org

Latest orphan designations and/or marketing authorisations | www.eurordis.org


Latest orphan designations and/or marketing authorisations


October 2012
Treatment of cystic fibrosis
Alpha-1 proteinase inhibitor (for inhalation use)

Treatment of fragile X syndrome

Treatment of acute lung injury

Treatment of pancreatic cancer
Mixture of two allogeneic human pancreatic cancer cell lines stably transduced with a retroviral vector encoding the murine alpha-(1,3)-galactosyltransferase gene

Treatment of ovarian cancer

 Treatment of traumatic spinal cord injury

Treatment of lecithin cholesterol acyltransferase deficiency
Recombinant human lecithin cholesterol acyltransferase

Treatment of haemophilia A
Humanised monoclonal IgG4 antibody against tissue factor pathway inhibitor

Treatment of ovarian cancer

Treatment of chronic lymphocytic leukaemia

Treatment of peripheral T-cell lymphoma (nodal, other extranodal and leukaemic/disseminated)

Treatment of acute myeloid leukaemia
Liposomal daunorubicin
September 2012
Diagnosis of positive folate receptor status in ovarian cancer
N-[4-[[(2-amino-3,4-dihydro-4-oxo-6-pteridinyl)methyl]amino]benzoyl]-D-gamma-glutamyl-(2S)-2-amino-beta-alanyl-Lalpha-aspartyl-L-cysteine to be used with folic acid

Diagnosis of positive folate receptor status in ovarian cancer
Folic acid to be used with N-[4-[[(2-amino-3,4-dihydro-4-oxo-6-pteridinyl)methyl]amino]benzoyl]-D-gamma-glutamyl-(2S)-2-amino-beta-alanyl-Lalpha-


  • Dacogen (decitabine)

acute myeloid leukaemia (AML)
Janssen-Cilag International NV, Belgium
What is Dacogen?
Dacogen is a powder that is made up into a solution for infusion (drip into a vein). It contains the active substance decitabine.
What is Dacogen used for?
Dacogen is used to treat adults aged 65 or older with acute myeloid leukaemia (AML), a type of cancer affecting the white blood cells. It is used in patients with newly diagnosed AML who are not eligible for initial treatment with standard chemotherapy (anticancer medicines).
Because the number of patients with AML is low, the disease is considered ‘rare’, and Dacogen was designated an ‘orphan medicine’ (a medicine used in rare diseases) on 8 June 2006.
The medicine can only be obtained with a prescription.
  • Revestive (teduglutide)

Short bowel syndrome
Nycomed Danmark APS

What is Revestive?
Revestive is a medicine that contains the active substance teduglutide. It is available as a powder and a solvent to be made up into a solution for injection.
What is Revestive used for?
Revestive is used to treat adults with short bowel syndrome. Short bowel syndrome is a condition in which nutrients and fluids are not properly absorbed by the gut, usually following the surgical removal of a large portion of the small intestine. Revestive is used after ‘intestinal adaptation’ has occurred (changes in the function of the bowel to compensate for its reduced size following surgery).
Because the number of patients with short bowel disease is low, the disease is considered ‘rare’, and Revestive was designated an ‘orphan medicine’ (a medicine used in rare diseases) on 11 December 2001.
The medicine can only be obtained with a prescription.
  • Jakavi (ruxolitinib)

Novartis Europharm Limited, UK

What is Jakavi?
Jakavi is a medicine that contains the active substance ruxolitinib. It is available as tablets (5, 15 and 20 mg).
What is Jakavi used for?
Jakavi is used to treat adults with myelofibrosis who have splenomegaly (enlarged spleen) or symptoms related to the disease such as fever, night sweats, bone pain and weight loss.
Myelofibrosis is a disease in which the bone marrow becomes very dense and rigid and produces abnormal, immature blood cells. Jakavi can be used in three types of the disease: primary myelofibrosis (also known as chronic idiopathic myelofibrosis, where the cause is unknown), post polycythaemia vera myelofibrosis (where the disease is linked to an overproduction of red blood cells) and post essential thrombocythaemia myelofibrosis (where the disease is linked to an overproduction of platelets, components that help the blood to clot).
Because the number of patients with these diseases is low, they are considered ‘rare’, and Jakavi was designated an ‘orphan medicine’ (a medicine used in rare diseases) for chronic idiopathic myelofibrosis on 7 November 2008 and for myelofibrosis secondary to polycythaemia vera or essential thrombocythaemia on 3 April 2009.
The medicine can only be obtained with a prescription.
  • Kalydeco (ivacaftor)

cystic fibrosis
Vertex Pharmaceuticals (U.K.) Ltd.

What is Kalydeco?
Kalydeco is a medicine that contains the active substance ivacaftor. It is available as tablets (150 mg).

What is Kalydeco used for?
Kalydeco is used to treat cystic fibrosis in patients aged six years and above who have the G551D mutation in their gene for the protein called cystic fibrosis transmembrane conductance regulator (CFTR). Cystic fibrosis is an inherited disease that affects the cells that secrete mucus in the lungs, and the cells that secrete digestive juices from the glands in the gut and pancreas. In cystic fibrosis these secretions become thick, blocking the airways and the flow of digestive juices. This leads to problems with the digestion and absorption of food, resulting in poor growth, and long-term infection and inflammation of the lungs because of excess mucus not being cleared away. Because the number of patients with cystic fibrosis is low, the disease is considered ‘rare’, and Kalydeco was designated an ‘orphan medicine’ (a medicine used in rare diseases) on 8 July 2008.
The medicine can only be obtained with a prescription.
Detailed information on European orphan drug designation applications is available on the EMA website
A full list of designated and authorised orphan drugs in Europe available at: ec.europa.eu
Page created: 27/04/2012
Page last updated: 30/10/2012

The last marathon - Waldenstrom macroglobulinemia community - RareConnect

The last marathon - Waldenstrom macroglobulinemia community - RareConnect

Waldenström macroglobulinemia (WM) is a rare form of blood cancer.

The last marathon

Written by giorgio_va, published 11 days ago.
I am a 66 year old man and I retired 11 years ago. Every year, for the past last eight years I have always run an official marathon. After the last race, a year ago, a casual check up revealed a suspicious monoclonal component. Ensuing exams have confirmed the diagnosis of Waldenstrom Macroglobulenemia. No obvious symptoms, and a stable clinical situation, which indicates that for the moment there is no need to start a treatment. But what will the evolution be?
I am a 66 year old man. I have worked for major corporations, with frequent trips abroad, especially in the last years of my career, and I retired 11 years ago. I've always loved sports and, given my sedentary work, carried out mainly in the office, I tried to do sports any time it was possible in order to keep fit.
After I turned 40 years old, I wanted to try running, and gradually I started running longer and longer distances, until I reached the marathon. This activity has become the measure of my well-being, and keeps me in shape, both physically and psychologically.
In each of the last 8 years I've run an official marathon, making it in around 4 hours.
Last year I carried out a perfect workout plan, and I ran the race (Venice Marathon) in 3 hours 55'10". When I crossed the finish line I didn't even feel the need to sit down, I changed standing up! Fantastic!
After a month, during a cardiac check up for a few episodes of high blood pressure, I gave the doctor my latest blood tests. Dated back almost a year before, I had taken them in preparation for surgery (removal of the parathyroid glands). And no doctor had pointed out the chart that appeared at the end, a curve of almost insignificant entity, but which indicated a suspicious monoclonal component (18%).
From there it all started.
The following tests confirmed a 22% monoclonal component, IgM value of 1950 mg/dL, and K chains. In the urine test Bence Jones protein and K free chains were found.
Diagnosed with MGUS, I was prescribed a series of check ups. Abdomen EG, chest CT scan, low-dose total body CT scan, Creatine Clearance. All were negative.
In March 2012, however, they carried out a BOM, which showed a lymphoplasmacytic lymphoma (IgM and CD 20+), with residual bone marrow of approximately 40%. Based on these tests, and on the blood tests, the diagnosis of Waldenstrom's Syndrome was confirmed, and I was told to continue the tests every three months.
In July, the gamma globulin decreased to 20%, my blood tests are stable, but the creatinine remains around the value of 1.4.
Despite what seemed to be stable to me, my doctor wanted me to begin the therapy with bendamustine and Rituxan in October.
I was puzzled and following my family's pressure, I consulted the chief of oncology at the San Raffaele in Milan. After visiting me and having examined the blood levels, the Chief confirms that his approach is not to start therapy for the time being.
In early October, my blood tests again confirmed to be stable, with gamma globulin at 20.4%. Considering the opinion of the chief of the San Raffaele, even the oncologist who was treating me at this point decided to postpone therapy, and tells me to go for follow up visits every four months.
This is the story from a clinical point of view.
From a physical point of view: Physically I haven't (yet) any noticeable symptoms. Psychologically, after the assignment of the "pink card" exemption for health service payments, due to a serious illness, it was a hard blow.
What will happen? Is it just a matter of time, and then the first symptoms will appear, and I will have to face the evidence of my illness and start treatment? How much time?
Under present conditions, my life could continue with the same pace as before, the same interests, if it weren't for this nagging question.
On the other hand, sometimes I think that this notice gives me a chance to get used to the idea and to face what might happen sooner or later.
When I look at the cases reported by some other members of the community, I think I should still feel lucky, because this disease struck me at a quite advanced age. Therefore, even with their help, I can exercise to run this last marathon in the best way.

EURORDIS conducts pilot survey to explore off-label use of medicines for rare diseases | www.eurordis.org

EURORDIS conducts pilot survey to explore off-label use of medicines for rare diseases | www.eurordis.org


EURORDIS conducts pilot survey to explore off-label use of medicines for rare diseases

Know more about off-label drug use for rare diseasesWhen doctors prescribe a medicine for a use different from what is authorised on the label, this is called “off label” use. For example when the drug is prescribed for a different disease or when the dosage differs from the one stated on the label. Patients with rare diseases and their families are often familiar with this practice, or may not even realise that they are taking products that are prescribed “off-label”.

In order to explore and better understand “off-label” drug use, EURORDIS’ DITA (Drug Information, Transparency and Access) task force conducted a pilot survey from May to July 2012. For example, one parent, who responded to the pilot survey, described using a product to treat his 6-month old’s epilepsy, whereas the label indicated that the drug is not recommended for children between the ages of six months and three years. The enquiry received over 250 responses, describing experiences with over 100 different medications for 90 different rare diseases. The preliminary results were presented to the European Medicines Agency in London last September.
The good news is that 86% of the respondents were satisfied by their experience using prescribed medicines “off-label”. The bad news is that 3 out of 4 people answering the survey would have liked more information about the benefits and risks of taking the drug “off-label”, and 1 out of 4 were not even told that the drug prescribed was “off-label” and therefore not recommended. In addition, one-third of the respondents experienced side effects.
EURORDIS has decided to continue its research into rare disease “off-label” use and to expand it to more patients in more countries. Future plans are to:
  • Build a database on off-label use in rare diseases;
  • Engage a dialogue with regulators on how to obtain more data on the benefits and risks of off-label uses, in particular with experts of the European Medicines Agency who are best placed to explore the data when available;
  • Discuss the utility of a consent form;
  • Explore other sources of information on off-label use in rare diseases, in particular by collaborating to healthcare professionals.
Page created: 30/10/2012
Page last updated: 31/10/2012EURORDIS conducts pilot survey to explore off-label use of medicines for rare diseases | www.eurordis.org

New Video on Culture, Language and Health Literacy

New Video on Culture, Language and Health Literacy

New Video on Culture, Language and Health Literacy

New Video on Culture, Language and Health Literacy
The Health Resources and Services Administration (HRSA), AHRQ’s sister agency, has released a new video discussing how culture, language, and health literacy are important to effective health communication. The video also describes HRSA’s free online course, "Effective Communication Tools for Health Care Professionals."
To access the video “Culture, Language and Health Literacy” go to: http://www.hrsa.gov/culturalcompetence
To access “Effective Communication Tools for Health Care Professionals” go to: www.hrsa.gov/publichealth/healthliteracy/index.html
You can find additional links to health literacy and cultural competence resources from the Department of Health and Human Services on AHRQ’s Browse page at: www.ahrq.gov/browse/hlitres.htm


Miércoles 31 de OCTUBRE de 2012

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Las lecturas indicadas entre paréntesis pertenecen a los registros MOTIGO que no aparecen en las estadísticas Google, no obstante el Blog se rige por la información Google.
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