Musculoskeletal Disorders in Northeast Lobstermen

BACKGROUND: The objective of this study was to report on the prevalence of musculoskeletal pain in lobstermen in the northeast USA. METHODS: Crews were randomly selected from those licensed to fish in Maine and Massachusetts and followed prospectively. The survey used a Nordic Musculoskeletal Questionnaire format to characterize musculoskeletal disorders. RESULTS: A total of 395 individuals participated. One half of the respondents reported low back pain. Back pain was attributed to or exacerbated by lobstering. Low back pain was prevalent among both captains and sternmen, while sternmen reported more hand/wrist pain than captains. Multiple locations for pain were common in individual participants. CONCLUSION: Equipment or technology to assist material handling should be a priority, as the body segments with high prevalence of pain (back, hand/wrists, shoulders, knees) are all affected by the repetitive and forceful handling of the lobster traps.

Evaluation of Urinary Antigen Test for Rapid Diagnosis of Community-Acquired Pneumococcal Pneumonia / 대한임상미생물학회지

BACKGROUND: Streptococcus pneumoniae is one of the most common pathogens of communityacquired pneumonia (CAP) which needs rapid diagnosis and appropriate therapeutic approaches. We evaluated a new rapid urinary antigen test kit, NOW S. pneumoniae antigen test (Binax Inc., Maine, USA), for the detection of the S. pneumoniae antigen in the urine of patients who were suspected of CAP. METHODS: A total of 115 urine samples were tested during April to July, 2004. Patients were divided into 2 groups: the first was the patients who were suspected of CAP and the second was the patients with other disorders. Urinary antigen test was performed done by immunochromatographic methods and results were read within 15 minutes. All the urine samples were random and unconcentrated. The patients were reviewed clinically, together with the results of sputum and blood cultures, urinalysis and other laboratory tests. RESULTS: Overall mean age was 62-years old and male proportion was 59%: Group 1 had mean age of 63-years old and male 54% whereas group 2 had 60-years old and 76%. S. pneumoniae antigen was detected in the urine from 14 (12.2%) of 115 patients. Of the 14 patients with positive urinary antigen tests, 12 were from 90 patients with CAP with fever, leukocytosis and appropriate radiological findings, giving the sensitivity of 13.3%; the remaining 2 patients were from 25 patients with other disorders. Only 2 of the 12 patients showed S. pneumoniae in sputum or blood cultures, respectively. Urinary antigen was not detected in 23 of the 25 patients with other disorders, giving the specificity of 92%. CONCLUSIONS: Since this simple and rapid urinary antigen test showed low sensitivity in this study, the clinical symptoms and signs and radiological findings of patients should be reviewed together with the results of the urine test for early and accurate diagnosis and treatment, consistent clinical symptoms and signs with radiological studies are inevitable. Thus further studies would be necessary. The urinary antigen test showed high specificity and therefore should be a useful adjunct to cultures to be in aid of the diagnosis of CAP.