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LAM Extra for General Practicioners

DECEMBER 05, 2014

[The prevalence of musculoskeletal symptoms among ambulance personnel in a national subsample]

PÉK Emese, BÁNFAI Bálint, DEUTSCH Krisztina, JEGES Sára, BETLEHEM József

[BACKGROUND - The ambulance workers face a lot of mental stress and physical demands in their everyday life. The physical demands can be originated from caring heavy equipment and moving patients. The poor mental health can strengthen physical problems, too. In this study our aim was to detect and compare the musculoskeletal status of ambulance personnel in two regions of Hungary. SAMPLE AND METHODS - On a voluntary base a cross-sectional anonymous, standardized self-fill-in questionnaire (Nordic Musculoskeletal Questionnaire) was used with additional items. All ambulance personnel over 18 years old were involved in the study who worked in direct patient care either in the North-Hungarian or in the West-Hungarian Region of the country. RESULTS - In the regional representative sample N=810 workers answered our questions. Out of them 587 persons (72.5%) reported about some musculoskeletal problem during his lifespan. Most of them suffered from lower back pain (448 persons, 55%), back pain (318 persons, 39%), neck pain (250 persons, 30.9%). Parallel with the aging and with the time spent working for the ambulance service more and more overall discomfort can be detected (p=0.013; p=0.020). Having a second job affected the level and frequency of discomfort negatively (p=0.005). CONCLUSIONS - More than 70% of the ambulance workers experienced musculoskeletal problem during his emergency workers carrier which may worsen the quality of his work and his personal life. To handle the situation primary prevention, screening and possibilities for recreation should be forced among ambulance workers. ]

Lege Artis Medicinae

NOVEMBER 20, 2014

[The prevalence of musculoskeletal symptoms among ambulance personnel in a national subsample]

PÉK Emese, BÁNFAI Bálint, DEUTSCH Krisztina, JEGES Sára, BETLEHEM József

[BACKGROUND - The ambulance workers face a lot of mental stress and physical demands in their everyday life. The physical demands can be originated from caring heavy equipment and moving patients. The poor mental health can strengthen physical problems, too. In this study our aim was to detect and compare the musculoskeletal status of ambulance personnel in two regions of Hungary. SAMPLE AND METHODS - On a voluntary base a cross-sectional anonymous, standardized self-fill-in questionnaire (Nordic Musculoskeletal Questionnaire) was used with additional items. All ambulance personnel over 18 years old were involved in the study who worked in direct patient care either in the North-Hungarian or in the West-Hungarian Region of the country. RESULTS - In the regional representative sample N=810 workers answered our questions. Out of them 587 persons (72.5%) reported about some musculoskeletal problem during his lifespan. Most of them suffered from lower back pain (448 persons, 55%), back pain (318 persons, 39%), neck pain (250 persons, 30.9%). Parallel with the aging and with the time spent working for the ambulance service more and more overall discomfort can be detected (p=0.013; p=0.020). Having a second job affected the level and frequency of discomfort negatively (p=0.005). CONCLUSIONS - More than 70% of the ambulance workers experienced musculoskeletal problem during his emergency workers carrier which may worsen the quality of his work and his personal life. To handle the situation primary prevention, screening and possibilities for recreation should be forced among ambulance workers. ]

Lege Artis Medicinae

SEPTEMBER 22, 2013

[Letrozol therapy of postmenopausal women with early-stage breast carcinoma after four-six years of tamoxifen therapy: tolerability and quality of life]

TÓTH Éva Katalin, NEMESKÉRI Csaba, SZABÓ Barna, URBANCSEK Hilda, MÉSZÁROS Edina, NAGYKÁLNAI Tamás, PESTI Lajos, MARKÓ László, NAGY Beatrix, LANDHERR László

[INTRODUCTION - In patients with hormone- dependent breast cancer, five-year postoperative tamoxifen therapy is a standard treatment approach. Continuing this therapy for more than five years can increase the risk of recurrence of the disease. It has been shown that treatment with the third-generation aromatase inhibitor letrozol after discontinuation of tamoxifen therapy significantly improves disease-free survival. It is important to assess whether the substantial decrease of estrogen level shows a correlation with the occurrence of unwanted events/side effects or with changes in the quality of life. PATIENTS AND METHOD - Between 2005 and 2009, 921 women (mean age 63 years, age 40-94 years) with early-stage breast carcinoma were treated with expanded adjuvant letrozol therapy following tamoxifen treatment. Of these patients, 541 received previous tamoxifen therapy for 4-6 years. We studied relapses and quality of life - measured by the SF-36 survey - during letrozol therapy in the latter patient group and the occurrence of unwanted events and side effects in all 921 patients. The patients were examined eight times and completed the survey four times. RESULTS - At the check-ups, relapses were recorded in case of 20 patients. Quality of life scores significantly increased in two main categories - physical and mental health -, and within these in three subcategories, whereas decreasing scores were not recorded in any categories. In 921 patient taking letrozol, 73 experienced unwanted events/side effects, of which nine were severe and three patient died. The two most common side effects were joint and bone pain (18 patients) and heat rash (12 patients). CONCLUSION - Extended adjuvant therapy with letrozol efficiently decreased the number of relapses and the number of patients continuing therapy. On the basis of the SF-36 survey the patients’ quality of life generaly improved. Letrozol therapy was well tolerated by most patients, which can have a favourable effect on the outcome of the therapy.]