The impact of progressive lenses on head position in VDU operators

Bakgrund Muskuloskeletala besvär i nacke och skuldra är vanligt förekommande arbetsrelaterade sjukdomar bland bildskärmsarbetare. Detta orsakar individuellt lidande med stora kostnader för samhället i storleksordningen 0.5% till 2% av ett lands BNP, men även för företag som utöver ökade omkostnader även riskerar sämre produktion och kvalitet. Det finns en oro att bildskärmsarbetande med progressiva glasögon arbetar med en ökad huvudextension och huvudprotraktion sk ”gamnacke”. Få jämförande studier har dock gjorts på HE respektive FHP vid användandet av progressiva glasögon, och ännu färre med subjekten i deras naturliga arbetsmiljö. Syfte – I denna studie undersöktes om det, i subjektens egen arbetsmiljö, föreligger ett samband mellan begreppet gamnacke och bildskärmsarbete vid användandet av progressiva glasögon avseende faktorerna FHP och HE jämfört med bildskärmsarbete utan progressiva glasögon. Subjekt –Datainsamlingen har skett på sju stycken olika företag i storstockholmsområdet under tidsperioden Mars-April 2017. Testgruppen bestod av 3 män och 7 kvinnor med en medelålder på 57,80 år (±8,18). Tid som de använt progressiva glasögon var 5,85 år (±5,59). kontrollgruppen bestod av 4 män och 6 kvinnor med en medelålder på 55,90 år (±3,60). Metod – Subjekten fotograferades med en smartphonekamera i ett stativ med horisontellt vattenpass, sittande vid sina skrivbord framför sina egna bildskärmar. Tre fotografier togs under 5 minuters tid på respektive subjekt. Subjekten var inte varse om exakt vid vilken tidpunkt fotografierna togs. En mobilapplikation användes för att ta ut vinklar för HE och FHP. Medelvärdena användes sedan för vidare analys med ett two-independent-sample test. Resultat – Testgruppens medelvärde för huvudets protraktion, TFHP var 42,20° (±7,15°). Testgruppens vinkel för mätning av huvudets extension, THE, hade medelvärdet 17,73° (±5,55°). Kontrollgruppens medelvärde för huvudets protraktion, KFHP var 40,87° (±7,53°). Kontrollgruppens medelvärde av huvudets extension, KHE var 11,53° (±7,42°). Korrelationen mellan progressiva glasögon och FHP var inte statistisk signifikant (p = 0,739), detta gällde även för korrelationen mellan progressiva glasögon och HE (p = 0,063). Konklusion – Resultatet av studien visade inget statistiskt signifikant samband gällande att bildskärmsarbetande i subjektetens naturliga arbetsmiljö med fullprogressiva glasögon hade en högre grad FHP eller HE än bildskärmsarbetande utan fullprogressiva glasögon i förhållande till lodlinjen respektive horisontallinjen, däremot sågs en tendens till en högre grad av HE hos gruppen med fullprogressiva glasögon i förhållande till horisontallinjen (p=0,063).Introduction – Musculoskeletal disorders of the neck and shoulders are common occupational diseases among VDU operators. This causes individual suffering with high costs for society at around 0.5% to 2% of a countries GDP, as well as for companies, that besides high costs also risk a poorer production and quality. There is a concern that VDU operators with progressive lenses have an increased head extension and Forward head posture. However, Few comparative studies have been made on head extension and Forward head posture on subjects with progressive lenses and even fewer with subjects in their natural working environment. Aim – In this study, the aim was to, in the subjects own natural working environment, investigate whether there is a connection between the concept of poor posture in regards of FHP and HE, and VDU operators in the use of progressive lenses, compared to VDU operators without progressive lenses. Materials – The data was collected from seven different companies in the Greater Stockholm area during the period March-April 2017. The test group consisted of 3 men and 7 women with an average age of 57.80 years (± 8.18). The time spent using progressive lenses was 5.85 years (± 5.59). The control group consisted of 4 men and 6 women with an average age of 55.90 years (± 3.60). Method - The subjects were photographed with a smartphone on a leveled tripod, sitting at their own desks in front of their own monitors. Three photos were taken within 5 minutes on each subject. The subjects did not know exactly when the photographs were taken. A mobile application was used to extract angles for HE and FHP measurements. The mean values were then used for further analysis with a two-independent sample test. Results – The test group's mean head protrusion, TFHP was 42.20° (±7.15°). The test group's angle for measuring the head extension, THE, had an average of 17.73° (±5.55°). The control group's mean head protrusion, KFHP was 40.87° (±7.53°). The control group's mean of the head extension, KHE was 11.53° (±7.42°). The correlation between progressive lenses and FHP was not significant (p = 0.739), nor was the correlation between progressive lenses and HE significant (p = 0.063). Conclusion – The results of the study showed no statistically significant correlation that VDU operators in the subject's natural working environment with progressive lenses have a higher degree of FHP or HE than VDU operators without progressive lenses in relation to the vertical- and horizontal line respectively. On the other hand, they had a trend towards a higher HE than VDU operators without progressive lenses with a p-value of 0.063

The impact of progressive lenses on head position in VDU operators

Bakgrund Muskuloskeletala besvär i nacke och skuldra är vanligt förekommande arbetsrelaterade sjukdomar bland bildskärmsarbetare. Detta orsakar individuellt lidande med stora kostnader för samhället i storleksordningen 0.5% till 2% av ett lands BNP, men även för företag som utöver ökade omkostnader även riskerar sämre produktion och kvalitet. Det finns en oro att bildskärmsarbetande med progressiva glasögon arbetar med en ökad huvudextension och huvudprotraktion sk ”gamnacke”. Få jämförande studier har dock gjorts på HE respektive FHP vid användandet av progressiva glasögon, och ännu färre med subjekten i deras naturliga arbetsmiljö. Syfte – I denna studie undersöktes om det, i subjektens egen arbetsmiljö, föreligger ett samband mellan begreppet gamnacke och bildskärmsarbete vid användandet av progressiva glasögon avseende faktorerna FHP och HE jämfört med bildskärmsarbete utan progressiva glasögon. Subjekt –Datainsamlingen har skett på sju stycken olika företag i storstockholmsområdet under tidsperioden Mars-April 2017. Testgruppen bestod av 3 män och 7 kvinnor med en medelålder på 57,80 år (±8,18). Tid som de använt progressiva glasögon var 5,85 år (±5,59). kontrollgruppen bestod av 4 män och 6 kvinnor med en medelålder på 55,90 år (±3,60). Metod – Subjekten fotograferades med en smartphonekamera i ett stativ med horisontellt vattenpass, sittande vid sina skrivbord framför sina egna bildskärmar. Tre fotografier togs under 5 minuters tid på respektive subjekt. Subjekten var inte varse om exakt vid vilken tidpunkt fotografierna togs. En mobilapplikation användes för att ta ut vinklar för HE och FHP. Medelvärdena användes sedan för vidare analys med ett two-independent-sample test. Resultat – Testgruppens medelvärde för huvudets protraktion, TFHP var 42,20° (±7,15°). Testgruppens vinkel för mätning av huvudets extension, THE, hade medelvärdet 17,73° (±5,55°). Kontrollgruppens medelvärde för huvudets protraktion, KFHP var 40,87° (±7,53°). Kontrollgruppens medelvärde av huvudets extension, KHE var 11,53° (±7,42°). Korrelationen mellan progressiva glasögon och FHP var inte statistisk signifikant (p = 0,739), detta gällde även för korrelationen mellan progressiva glasögon och HE (p = 0,063). Konklusion – Resultatet av studien visade inget statistiskt signifikant samband gällande att bildskärmsarbetande i subjektetens naturliga arbetsmiljö med fullprogressiva glasögon hade en högre grad FHP eller HE än bildskärmsarbetande utan fullprogressiva glasögon i förhållande till lodlinjen respektive horisontallinjen, däremot sågs en tendens till en högre grad av HE hos gruppen med fullprogressiva glasögon i förhållande till horisontallinjen (p=0,063).Introduction – Musculoskeletal disorders of the neck and shoulders are common occupational diseases among VDU operators. This causes individual suffering with high costs for society at around 0.5% to 2% of a countries GDP, as well as for companies, that besides high costs also risk a poorer production and quality. There is a concern that VDU operators with progressive lenses have an increased head extension and Forward head posture. However, Few comparative studies have been made on head extension and Forward head posture on subjects with progressive lenses and even fewer with subjects in their natural working environment. Aim – In this study, the aim was to, in the subjects own natural working environment, investigate whether there is a connection between the concept of poor posture in regards of FHP and HE, and VDU operators in the use of progressive lenses, compared to VDU operators without progressive lenses. Materials – The data was collected from seven different companies in the Greater Stockholm area during the period March-April 2017. The test group consisted of 3 men and 7 women with an average age of 57.80 years (± 8.18). The time spent using progressive lenses was 5.85 years (± 5.59). The control group consisted of 4 men and 6 women with an average age of 55.90 years (± 3.60). Method - The subjects were photographed with a smartphone on a leveled tripod, sitting at their own desks in front of their own monitors. Three photos were taken within 5 minutes on each subject. The subjects did not know exactly when the photographs were taken. A mobile application was used to extract angles for HE and FHP measurements. The mean values were then used for further analysis with a two-independent sample test. Results – The test group's mean head protrusion, TFHP was 42.20° (±7.15°). The test group's angle for measuring the head extension, THE, had an average of 17.73° (±5.55°). The control group's mean head protrusion, KFHP was 40.87° (±7.53°). The control group's mean of the head extension, KHE was 11.53° (±7.42°). The correlation between progressive lenses and FHP was not significant (p = 0.739), nor was the correlation between progressive lenses and HE significant (p = 0.063). Conclusion – The results of the study showed no statistically significant correlation that VDU operators in the subject's natural working environment with progressive lenses have a higher degree of FHP or HE than VDU operators without progressive lenses in relation to the vertical- and horizontal line respectively. On the other hand, they had a trend towards a higher HE than VDU operators without progressive lenses with a p-value of 0.063

The impact of progressive lenses on head position in VDU operators

Bakgrund Muskuloskeletala besvär i nacke och skuldra är vanligt förekommande arbetsrelaterade sjukdomar bland bildskärmsarbetare. Detta orsakar individuellt lidande med stora kostnader för samhället i storleksordningen 0.5% till 2% av ett lands BNP, men även för företag som utöver ökade omkostnader även riskerar sämre produktion och kvalitet. Det finns en oro att bildskärmsarbetande med progressiva glasögon arbetar med en ökad huvudextension och huvudprotraktion sk ”gamnacke”. Få jämförande studier har dock gjorts på HE respektive FHP vid användandet av progressiva glasögon, och ännu färre med subjekten i deras naturliga arbetsmiljö. Syfte – I denna studie undersöktes om det, i subjektens egen arbetsmiljö, föreligger ett samband mellan begreppet gamnacke och bildskärmsarbete vid användandet av progressiva glasögon avseende faktorerna FHP och HE jämfört med bildskärmsarbete utan progressiva glasögon. Subjekt –Datainsamlingen har skett på sju stycken olika företag i storstockholmsområdet under tidsperioden Mars-April 2017. Testgruppen bestod av 3 män och 7 kvinnor med en medelålder på 57,80 år (±8,18). Tid som de använt progressiva glasögon var 5,85 år (±5,59). kontrollgruppen bestod av 4 män och 6 kvinnor med en medelålder på 55,90 år (±3,60). Metod – Subjekten fotograferades med en smartphonekamera i ett stativ med horisontellt vattenpass, sittande vid sina skrivbord framför sina egna bildskärmar. Tre fotografier togs under 5 minuters tid på respektive subjekt. Subjekten var inte varse om exakt vid vilken tidpunkt fotografierna togs. En mobilapplikation användes för att ta ut vinklar för HE och FHP. Medelvärdena användes sedan för vidare analys med ett two-independent-sample test. Resultat – Testgruppens medelvärde för huvudets protraktion, TFHP var 42,20° (±7,15°). Testgruppens vinkel för mätning av huvudets extension, THE, hade medelvärdet 17,73° (±5,55°). Kontrollgruppens medelvärde för huvudets protraktion, KFHP var 40,87° (±7,53°). Kontrollgruppens medelvärde av huvudets extension, KHE var 11,53° (±7,42°). Korrelationen mellan progressiva glasögon och FHP var inte statistisk signifikant (p = 0,739), detta gällde även för korrelationen mellan progressiva glasögon och HE (p = 0,063). Konklusion – Resultatet av studien visade inget statistiskt signifikant samband gällande att bildskärmsarbetande i subjektetens naturliga arbetsmiljö med fullprogressiva glasögon hade en högre grad FHP eller HE än bildskärmsarbetande utan fullprogressiva glasögon i förhållande till lodlinjen respektive horisontallinjen, däremot sågs en tendens till en högre grad av HE hos gruppen med fullprogressiva glasögon i förhållande till horisontallinjen (p=0,063).Introduction – Musculoskeletal disorders of the neck and shoulders are common occupational diseases among VDU operators. This causes individual suffering with high costs for society at around 0.5% to 2% of a countries GDP, as well as for companies, that besides high costs also risk a poorer production and quality. There is a concern that VDU operators with progressive lenses have an increased head extension and Forward head posture. However, Few comparative studies have been made on head extension and Forward head posture on subjects with progressive lenses and even fewer with subjects in their natural working environment. Aim – In this study, the aim was to, in the subjects own natural working environment, investigate whether there is a connection between the concept of poor posture in regards of FHP and HE, and VDU operators in the use of progressive lenses, compared to VDU operators without progressive lenses. Materials – The data was collected from seven different companies in the Greater Stockholm area during the period March-April 2017. The test group consisted of 3 men and 7 women with an average age of 57.80 years (± 8.18). The time spent using progressive lenses was 5.85 years (± 5.59). The control group consisted of 4 men and 6 women with an average age of 55.90 years (± 3.60). Method - The subjects were photographed with a smartphone on a leveled tripod, sitting at their own desks in front of their own monitors. Three photos were taken within 5 minutes on each subject. The subjects did not know exactly when the photographs were taken. A mobile application was used to extract angles for HE and FHP measurements. The mean values were then used for further analysis with a two-independent sample test. Results – The test group's mean head protrusion, TFHP was 42.20° (±7.15°). The test group's angle for measuring the head extension, THE, had an average of 17.73° (±5.55°). The control group's mean head protrusion, KFHP was 40.87° (±7.53°). The control group's mean of the head extension, KHE was 11.53° (±7.42°). The correlation between progressive lenses and FHP was not significant (p = 0.739), nor was the correlation between progressive lenses and HE significant (p = 0.063). Conclusion – The results of the study showed no statistically significant correlation that VDU operators in the subject's natural working environment with progressive lenses have a higher degree of FHP or HE than VDU operators without progressive lenses in relation to the vertical- and horizontal line respectively. On the other hand, they had a trend towards a higher HE than VDU operators without progressive lenses with a p-value of 0.063

Prediction of changes in bone density after operation for primary hyperparathyroidism

Primary hyperparathyroidism (pHPT) is associated with osteopenia. However, the individual variation in recovery in bone mass after surgery is large. Therefore, modes of prediction of the increase in bone mass after parathyroid surgery were investigated. Preoperatively and at one year after surgery bone mineral content (BMC) in the distal radius was measured with single photon absorptiometry technique in 40 patients with pHPT. Serum levels of calcium, intact parathyroid hormone (PTH), alkaline phosphatase, osteocalcin and Vitamin D metabolites were also determined. Preoperatively, Z-score of BMC was -0.85 +/- 1.20 SD below the normal mean. There was a modest association between BMC and serum levels of osteocalcin (r = -0.34; P < 0.05), and dihydroxycholecalciferol (r = -0.35; P < 0.05). At one year after surgery, mean BMC increased by 2% (P < 0.05), but with a wide dispersion. Preoperative Z-score of BMC correlated with the relative change in BMC (r = -0.33; P < 0.05). An increase in BMC with 95% confidence was evident in 10 of the patients. None of these patients had a preoperative Z-score of BMC above the mean expected for age and sex. We conclude that the increase in bone mass after surgery for pHPT is small and evident only in a portion (approximately 25%) of patients. Hence, a decrease in bone mass should not be a major indication for surgery in pHPT

Biochemical variables associated with bone density in patients with primary hyperparathyroidism

OBJECTIVE: To clarify the association between primary hyperparathyroidism and cortical osteopenia.DESIGN: Open study.SETTING: Department of Surgery, University of Lund, Sweden.SUBJECTS: 38 patients with primary hyperparathyroidism.OUTCOME MEASURES: Correlation between bone density (measured by single photon absorption) and age; sex; serum concentrations of parathyroid hormone and ionised calcium; serum alkaline phosphatase activity; and serum concentration of calcium, phosphate, creatinine, urea, osteocalcin, 25 hydroxycholecalciferol, and 1,25 dihydroxycholecalciferol.RESULTS: There was no difference in bone density between men and women. There was no correlation between bone density and severity of hypercalcaemia or age. No biochemical abnormality was peculiar to the seven patients whose bone density was more than two SD below the population mean. Serum concentrations of 1,25 dihydroxycholecalciferol and osteocalcin both correlated significantly with bone density (p < 0.05) and there was a strong correlation between serum osteocalcin and serum intact parathyroid hormone (p < 0.001). Serum osteocalcin had the strongest correlation with bone density of any of the biochemical variables.CONCLUSION: There is little association between bone density and serum concentration of parathyroid hormone

Long-term metabolic effects of urinary diversion on skeletal bone: histomorphometric and mineralogic analysis

OBJECTIVES. To evaluate the long-term influence of different types of intestinal urinary diversion on skeletal bone and its mineral content. METHODS. Densitometry was used to estimate bone mineral content, and bone biopsies were analyzed with histomorphometric technique. The study comprised 20 patients with conduit urinary diversion and 19 with cecal continent reservoir, all followed up for more than 5 years, with normal or near-normal renal function. RESULTS. Bone mineral content did not differ significantly between the patients with cecal continent urinary reservoir and those with conduit diversion or between these groups and a reference group. At the cellular level, the histomorphometric analysis revealed no defective bone mineralization or increased bone resorption in either group of patients. The trabecular bone volume was greater than normal in the reservoir group, but not in the conduit group. The appositional rate was significantly below normal in both groups of patients, but did not differ between conduit and reservoir patients. CONCLUSIONS. Subtle changes in electrolytes and acid-base homeostasis identified in adults with intestinal segments incorporated in the urinary tract and with largely normal renal function do not seem to influence bone mineralization in the long term. At the cellular level, a lower than normal appositional rate was found in the patients with conduit or continent urinary diversion. In the latter group, this finding, together with increased trabecular bone volume, may indicate a decrease of bone turnover

Thirty-five years of hemodialysis: two case reports as a tribute to Nils Alwall.

Two patients with long-term (35 years) survival on hemodialysis are described. Kidney replacement therapy for these patients was initiated by a pioneer in hemodialysis, Nils Alwall, in 1968 and 1971, respectively. Kidney transplantation was attempted twice in both patients; however, the dialysis-free interval was less than 18 months in both patients. These patients represent two of the longest known survivors on hemodialysis worldwide. Factors that may have influenced their survival are discussed, and the complications that have occurred over the years are presented

Can DXA Predict Fractures in Renal Transplant Patients?

Renal transplant patients have a high prevalence of osteopenia, osteoporosis and fractures. The aim of the study was to investigate whether dual-energy x-ray absorptiometry (DXA) is of value to predict fractures. In 1995-2007, 238 renal transplant patients underwent 670 DXA investigations. Osteopenia (46.0%), osteoporosis (13.9%) and absolute bone mineral density (BMD) (median 0.9, range 0.4-2.0 g/cm(2)) in the hip region were used to evaluate fracture risk. Data on fractures were collected at the occasion of each DXA, and a questionnaire was filled in by 191 patients at regular outpatient visits. Reported fractures were verified by consultation of medical records. In all, 46 patients had 53 fractures. Cumulative hazard of fracture was significantly different among normal BMD, osteopenia and osteoporosis in the hip (p < 0.0001). A Cox proportional hazard analysis also including age, gender and diabetic nephropathy showed significantly increased fracture risk for osteoporosis (3.5 times, CI 1.8-6.4, p = 0.0001) as well as for osteopenia (2.7 times, 1.6-4.6, p = 0.0003). A significantly increased risk was also found with absolute BMD estimates below the median. Osteopenia and an absolute bone density below 0.9 g/cm(2) in the hip region confer an increased risk of fracture