Background and study aims Previous studies have suggested a high prevalence of musculoskeletal injuries (MI) in endoscopists. Little evidence has come from European countries. Our main aim was to evaluate the prevalence, type, and impact of MI among Portuguese endoscopists. We also sought to identify risk factors for the development, severity and number of endoscopy-related MI. Material and methods A 48-question electronic survey was developed by a multidisciplinary group. The electronic survey was sent to all members of Portuguese Society of Gastroenterology (n = 705) during May 2019. Study data were collected and managed using REDCap electronic data capture tools hosted at SPG – CEREGA. Results The survey was completed by 171 endoscopists (response rate of 24.3 %), 55.0 % female with a median age of 36 years (range 26–78). The prevalence of at least one MI related to endoscopy was 69.6 % (n = 119), the most frequent being neck pain (30.4 %) and thumb pain (29.2 %). The median time for MI development was 6 years (range 2 months-30 years). Severe pain was reported by 19.3 %. Change in endoscopic technique was undertaken by 61.3 % and reduction in endoscopic caseload was undertaken by 22.7 %. Missing work was reported by 10.1 %, with the median time off from work being 30 days (range 1–90). Female gender and ≥ 15 years in practice were independently associated with MI and severe pain. Years in practice, weekly-time performing endoscopy, and gender were significant predictors of the number of MI. Conclusions Prevalence of MI was significant among Portuguese endoscopists and had a relevant impact on regular and professional activities.
The present study aimed to determine the effects of a physical activity program on the functional autonomy of elderly women. The sample was divided into an experimental group (EG; n = 20; 68.51 ± 5.02 years; BMI = 27.01 ± 4.35) submitted to a physical activity program, and a control group (CG; n = 20; 67.01 ± 3.51 years; BMI = 26.71 ± 5.74). Functional autonomy was assessed using tests from the GDLAM autonomy protocol: 10 meter walk test (10MW), rising from a sitting position (RSP), rising from a ventral decubitus position (RVDP), rising from a chair and moving around the house (RCMH) and putting on and taking off a t-shirt (PTT), after which the autonomy index (AI) was calculated. In the EG, ANOVA showed significant reductions in execution times for the RSP (∆ =-3.92 s; p = 0.0001), RCMH (∆ =-9.61 s; p = 0.0001), 10MW (∆ =-0.94 s; p = 0.038) and RVDP (∆ =-1.15 s; p = 0.036) tests, as well as the AI (∆ =-6.27; p = 0.0001). This was not observed in the CG. Intergroup comparisons demonstrated that execution times for the RSP (∆% =-36.63; p = 0.0001), RCMH (∆% =-20.27; p = 0.0001), 10mW (∆% =-12.54; p = 0.002) and RVDP (∆% =-25.10; p = 0.005) tests and the AI (∆% =-21.37; p = 0.0001) of the EG were shorter than those of the CG. These results indicate that elderly subjects in the EG showed improved performance in activities of daily living after engaging in physical exercise.
INTRODUCTION: The performance of endoscopy is characterized by frequent and repetitive activities. Endoscopists often report musculoskeletal injuries (MI). The widespread use of endoscopy and the execution of more technically challenging procedures may lead to higher rates of repetitive stress injuries. Despite previous American and Asian reports, little evidence has come from Europe. We aimed to determine the prevalence, risk factors and impact of MI among Portuguese endoscopists. METHODS: A 48-question electronic survey was developed by a multidisciplinary group. The electronic survey was sent to all members of Portuguese Society of Gastroenterology (SPG, n = 705) during May 2019. Study data were collected and managed using REDCap electronic data capture tools hosted at SPG–CEREGA. RESULTS: The survey was completed by 171 endoscopists (response rate of 24.3%), 55.0% female, with a median age of 36 years (31-50). The majority of the respondents were consultants (77.8%; trainees 22.2%), with 97.7% currently performing endoscopy. The median time of endoscopic practice was 9 years (5-22). Regarding practice setting, 52.0% worked in academic centers, 41.5% in community centers and 63.9% in private practice. The median weekly-working time was 50 hours (45-60), 50% (37.5-62.5%) performing endoscopy. The prevalence of reported MI was 69.6% (n = 119). The median time for MI development was 6 years (3-16). The most common sites of injury were neck (42.9%) and thumb (42.0%). In 45.4%, the pain was evident both in work and daily activities and 22.7% referred pain even at rest. In the respondents with MI, 34.5% changed practice and/or reduced working activity and 33.6% reduced work-unrelated physical activity. Missing work was reported by 10.1% [median 30 days (4-45)]. The most common treatments were NSAIDs (57.1%) and physiotherapy (30.3%) but surgery was required in 1.7%. In the multivariate logistic regression, endoscopic practice >15 years (OR 3.514, P = 0.004), female gender (OR 2.443, P = 0.018) and higher percentage of time performing upper endoscopy (OR 0.974, P = 0.026) were independently associated with MI. CONCLUSION: Musculoskeletal injuries were reported by over two thirds of the portuguese endoscopists that completed our survey. These injuries had a significant impact on regular and professional activities. Female endoscopists and those with a minimum of 15 years of practice are at higher risk. The identification of these risk factors may result in practice changes to reduce the burden of the injuries.
Background Primary hepatic lymphoma is a very uncommon disease. Due to its nonspecific clinical, laboratory, and imaging findings, it is often misdiagnosed. Liver biopsy is required to make a final diagnosis. Chemotherapy is the current gold standard of treatment. Case presentation An asymptomatic 65-year-old Caucasian man with Child-Pugh class A cirrhosis presented to our hospital with a nodular lesion seen on a routine surveillance abdominal ultrasound. His physical examination revealed hepatomegaly and no other significant findings. Magnetic resonance imaging of the abdomen showed a voluminous nodule on the left lobe with heterogeneous contrast enhancement. His liver biopsy was compatible with diffuse large B-cell lymphoma. Systemic staging showed no evidence of nodal or bone marrow involvement, confirming the diagnosis of primary hepatic lymphoma. He was treated with chemotherapy. However, he developed febrile neutropenia after one of the cycles and died. Conclusions In this article, we report a rare presentation of non-Hodgkin lymphoma and review the current literature on clinical features, diagnosis, and management.
Acute effects of static stretching on muscle strength Study aim: To assess the effects of static passive maximal stretching on muscle performance in order to clarify the existing controversies. Material and methods: Two randomly selected groups of the Brazilian Air Force personnel were studied: experimental (n = 15), subjected to 3 bouts of static passive stretching exercises of wrist flexors and extensors (beyond a mild discomfort). Every bout lasted 10 s and was followed by a 30-s rest. The control group (n = 15) performed no exercises. Muscle strength was measured with a handgrip dynamometer before and 20 min after the test. Results: Subjects from the experimental group had the pre-exercise handgrip strength significantly higher than postexercise (by about 7%; p<0.01). No significant decrease was noted in the control group. Conclusions: Static passive stretching induces decreases in muscle strength.
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