Time to diagnosis was long in CD. Physician-related delay in diagnosing CD was associated with increased overall complications and intestinal strictures (See Video Abstract, Supplemental Digital Content 1, http://links.lww.com/IBD/B646).
The sensitivity to lysis by complement of the erythrocytes of 56 patients with paroxysmal nocturnal haemoglobinuria (PNH) was compared to the membrane expression of decay accelerating factor (DAF, CD55), membrane inhibitor of reactive lysis (MIRL, CD59) and acetylcholinesterase (AChE). Most patients (36/50 72% in whom the analysis could be made) appeared to have erythrocytes of intermediate sensitivity to complement in the blood. These cells appeared as a discrete population of cells (PNH II cells), as a 'tail' of cells slightly less sensitive than the predominant PNH III cells (previously called PNH IIIb cells), or as a continuous spectrum of cells sensitive to complement. The PNH III cells totally lacked all three proteins (DAF, MIRL, AChE) by flow cytometric analysis whereas PNH I cells appeared to have normal or nearly normal amounts of each. The cells of intermediate sensitivity (PNH II) had coordinately decreased expression of all three proteins; the level of expression of DAF and MIRL paralleled the sensitivity of the cells to the haemolytic action of complement.
In this study the authors investigate the percentage of mismatch between job demands and worker physical capacity in Utah National Guard mechanics. This population had demonstrated a higher incidence of low back trouble than other job descriptions reviewed. The authors utilized onsite still and videotape photography and a computerized biomechanical strength prediction model to assess loads on the lumbosacral spine due to various job tasks. Job demands were then compared to the actual physical capacity of the individual workers based on static strength testing in job-related positions. A load cell on the testing apparatus entered the force generated into a computer which averaged the force of the last three seconds of a five-second lift. It was determined that as much as a 38% mismatch existed within this population for some job tasks which these workers were exposed to. Suggestions for preventing job-related low back cumulative trauma disorders are presented, including: engineering redesign, worker selection programs, work hardening, and others.
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