Preventive medicine of von Hippel-Lindau disease-associated pancreatic neuroendocrine tumors

Pancreatic neuroendocrine tumors (PanNETs) are rare in von Hippel-Lindau disease (VHL) but cause serious morbidity and mortality. Management guidelines for VHL-PanNETs continue to be based on limited evidence, and survival data to guide surgical management are lacking. We established the European-American-Asian-VHL-PanNET-Registry to assess data for risks for metastases, survival and long-term outcomes to provide best management recommendations. Of 2330 VHL patients, 273 had a total of 484 PanNETs. Median age at diagnosis of PanNET was 35 years (range 10-75). Fifty-five (20%) patients had metastatic PanNETs. Metastatic PanNETs were significantly larger (median size 5 vs 2\u2009cm; P\u20091.5\u2009cm in diameter were operated. Ten-year survival was significantly longer in operated vs non-operated patients, in particular for PanNETs <2.8\u2009cm vs 652.8\u2009cm (94% vs 85% by 10 years; P\u2009=\u20090.020; 80% vs 50% at 10 years; P\u2009=\u20090.030). This study demonstrates that patients with PanNET approaching the cut-off diameter of 2.8\u2009cm should be operated. Mutations in exon 3, especially of codons 161/167 are at enhanced risk for metastatic PanNETs. Survival is significantly longer in operated non-metastatic VHL-PanNETs

Development of normative data for cylindrical grasp pressure

Normative data of grasp strength (GS) are commonly used in working and clinical environments. Squeezing two parallel bars of a handgrip instrument is a common method to measure GS. These instruments require the use of hook grasp position which differentiates from the other types of power grasp in terms of inclusion of the thumb. Therefore, strength performance measured with these types of dynamometers cannot be generalizable to the other types of power grasp. Although several studies have been conducted to form normative data of hook and spherical grasp strengths, a satisfactory cylindrical grasp strength norm has not been reported yet. The measurement of grasp pressure (GP) is another way of establishing the grasping capabilities of the hand and the preferred method for fragile and weak hands. The purposes of the study were to develop normative data of cylindrical GP in a healthy population and to analyze the changes in the means according to physical demands of the subjects' jobs. 770 healthy subjects (382 females, 388 males) were found to be eligible to participate in the study. A custom-made adapted sphygmomanometer having a cylindrical air-filled bag was used to measure GP. Occupational categories of the subjects were determined based on the classification in the Dictionary of Occupational Titles. The subjects were accommodated to 12 age groups per gender of five-year intervals. The mean GP of the male subjects were higher than those of female subjects in each age group. There were significant differences between the dominant and non-dominant hands in both sexes. Subjects older than 70 years achieved the lowest values. The changes of the means over age were in compliance with the curvilinear function. Only age factor was found to be resulted in significant differences in GP means at both hands of the subjects. The minimum GP means were in the "sedentary" category at both sexes (F: 225, M: 315 mmHg in the dominant hands). Male subjects in the "very heavy" category produced the highest test means (M: 371 mmHg). Further analysis on 52 male subjects demonstrated that hand length, hand circumference and palm length had the highest correlations with GP scores in sequence

The effects of worksite exercises on physical capabilities of workers in an industry of a developing country: A randomized controlled study

WOS: 000383729700011BACKGROUND: Worksite exercise to promote health is a relatively new concept in the industries of developing countries. OBJECTIVES: The aim of this study was to investigate the first-time feasibilities and effects of worksite exercises on physical capabilities of workers in an industry with limited sport facilities. METHODS: A randomized controlled-study was conducted. Ninety-one female workers were randomly assigned to one of the three study groups: two exercise groups and a control group. The workers in the exercise groups participated in group exercises 3 times per week. Maximal oxygen consumption (VO(2)max), the level of hand skill, and hand grip strengths of the workers were measured before and after the 8-week intervention. RESULTS: Approximately 75% of the workers (n = 68) completed the study. Adherence was higher in the exercise groups. Overall, no improvement was observed in the control group. VO(2)max increased in both exercise groups (p < 0.05) but no difference was recorded between the groups. The level of hand skill was the least affected in all groups. Strengthening exercises conducted with elastic bands were superior to the repetitive movements in terms of strength gains. CONCLUSION: Exercises capable of improving physical fitness and strength can be integrated into the usual workflow of an industrial workplace with minimal cost. Ensuring sport facilities and instruments during all working hours may improve adherence to worksite exercises