Carpal tunnel syndrome (CTS) is a common medical condition that is a part of the broader group of cumulative trauma disorders (CTD). It is associated with a marked symptomatology resulting from entrapment of the median nerve at the wrist, and can have serious occupational and economic implications. Works involving repetitive wrist and arm movements and jobs requiring strong grip, use of vibrating tools, and working in a cold environment are all known risk factors for CTS [1][2][3] . The burden of occupation-related CTS is substantial 4,5) , in particular among those employed in high-risk occupations such as the food industry, postal workers, and health care personnel. In the U.S., cumulative trauma injuries and repeated trauma, of which CTS makes up a substantial fraction, represent about 65% of occupational injuries 5) .Studies have repeatedly demonstrated that under-recognition and under-reporting of work-related CTS are quite common 2, 5-7) , despite extensive description of the syndrome in the occupational and general medical literature [7][8][9] . Not infrequently, non-occupational physicians do not address the possible role of occupational risk-factors in the etiology of the syndrome during the evaluation of a particular patient. This situation is quite unfortunate as after the relationship between specific occupational factors and the occurrence of CTS is established, appropriate preventive measures can be taken to alleviate suffering and prevent further damage to the afflicted individual, as well as preventing fellow workers from developing similar symptoms.The purpose of this study is to evaluate the level of awareness of non-occupational physicians to the possible role of occupational risk factors in the development of CTS in individual patients. The study was carried out in a large regional outpatient service that provides care for approximately 10% of the population of Israel and it was approved by the ethics committee of the regional hospital. The study group was consisted of 229 individuals aged 25-65, who were operated at the outpatient surgical units of the regional health care service during a threeyear period (1st January 1999 to 31st December 2001). All CTS cases were diagnosed based on clinical symptoms and nerve conduction velocity (NCV) studies. Only patients with first operation for CTS were included. Controls were subjects matched by gender and age (± 2

SUMMARYPurpose: To examine the risk of undergoing an epileptic seizure as a function of differing levels of occupational stress (physical and mental) in new military recruits with no previous history of epilepsy or with epilepsy in remission for over 2 years. Methods: The medical records of over 300,000 18-year-old men recruited to the Israeli army between mid-eighties and mid-nineties were used to assemble a cohort, which was followed for a period of 30 months. The severity of epilepsy at recruitment was determined according to four categories, 0 (no history of seizures) and 1-3 (history of seizures with different relapse-free periods, with or without treatment). The soldiers were subdivided according to their occupational categories to: combat units (CU), maintenance units (MU), and administrative units (AU). The prevalence of epilepsy is 0.5-1% worldwide, with the highest incidence occurring in early childhood and late adulthood (Hauser et al., 1991). Studies on the risk for recurrent seizures show that between 27% and 81% of patients will suffer a second seizure within 3-5 years (Shinnar et al Results

BackgroundLow back pain (LBP) is a leading cause of referral to occupational health clinics and of consequent work absenteeism. There is lack of data concerning ages 18–21. The objective of our study was to evaluate the occurrence of newly diagnosed LBP and the recurrence and worsening of preexisting LBP in young male military recruits.MethodsIn this retrospective cohort study, we examined the medical history of army recruits during the 30-month period after their induction into the Israel Defense Forces (IDF). The duty status of soldiers in combat units (CU), maintenance units (MU) and administrative units (AU) was evaluated according to their morbidity. The study’s end point was defined as significant findings on clinical examination with presence of neurological deficits which correlate to radiological findings on CT or MRI showing herniated disks, spinal stenosis or pressure on neurological roots.ResultsThe annual incidence rate of LBP in a total of 159,295 recruits was 0.05 %. The relative risk (RR) for developing LBP was significantly higher among subjects who were assigned to AU as compared to CU and MU in all LBP categories. The RR for LBP recurrence in soldiers with a positive history of LBP (categories 3 and 4) was 4.1 and 10.7 compare to category 1 respectively.ConclusionsThe lower than expected overall incidence rate of 0.05 % reflects the fact that severe LBP occurrences are not common at this age group. This finding is a more truthful reflection of LBP occurrence rates relative to other studies since the end point is based on precise clinical definitions in medical records and not on questionnaires, as in most studies. The RR for developing LBP was significantly higher among subjects who were assigned to AU as compared to CU and MU in all LBP categories. Childhood history of LBP was found as a significant risk factor for LBP exacerbations at adulthood. Positive history of LBP was found as a risk factor for the recurrence of LBP in all occupation types and particularly in sedentary ones.

Physicians and rehabilitation staff should regard a high DASH score as a warning sign when assessing RTW prospects in ULD cases. It may be advisable to focus on workers with a large discrepancy between high DASH scores and low objective disability and to concentrate efforts appropriately.

Currently, a suspension of crushed tablets of amlodidpine is widely used in children with hypertension without knowledge of its bioavailability. A comparative bioavailability study of a tablet and suspension formulation of amlodipine was completed in 20 healthy adult volunteers. Bioequivalence of the suspension was not different from the tablets. These results support the use of the suspension in children who cannot take the tablet.