Workers' compensation, return to work, and patient satisfaction after carpal tunnel decompression.

In the study reported here, we assessed satisfaction and return to work in workers' compensation (WC) patients after carpal tunnel decompression. Eighty of the 362 patients who underwent surgery met the study criteria; 42 of the 80 were found for follow-up; 40 of the 42 participated in the telephone questionnaire; 15 (38%) of the 40 received WC; and 39 (98%) of the 40 returned to work. Mean age of the 40 respondents was 47 years, and mean follow-up was 29 months. WC involvement was not related to return to work and did not affect satisfaction with overall outcome but was related to dissatisfaction with job factors and timing of return to work.

Needlestick injuries among medical students.

BACKGROUND: Concern about occupational exposure to bloodborne pathogens exists, and medical students, who lack in experience in patient care and surgical technique, may be at an increased exposure risk. METHODS: This prospective cohort study evaluated needlestick injuries and practices regarding the use of protective strategies against bloodborne pathogens in medical students. A questionnaire was developed and sent to 224 medical students. RESULTS: Of 224 students, 146 students (64%) returned questionnaires. Forty-three students (30%) reported needlestick injuries that most commonly occurred in the operating room; 86% of students reported always using double gloves in the operating room; 90% reported always wearing eye protection, and all but one student had been vaccinated against hepatitis B. A concern about contracting a bloodborne pathogen through work was noted in 125 students, although they usually reported that this concern only slightly influenced their decision regarding a career subspecialty. CONCLUSION: Medical students have a high risk for needlestick injuries, and attention should be directed to protection strategies against bloodborne pathogens.

The effects of rapamycin in murine peripheral nerve isografts and allografts.

The FKBP-12-binding ligand FK506 has been successfully used to stimulate nerve regeneration and prevent the rejection of peripheral nerve allografts. The immunosuppressant rapamycin, another FKBP-12-binding ligand, stimulates axonal regeneration in vitro, but its influence on nerve regeneration in peripheral nerve isografts or allografts has not been studied. Sixty female inbred BALB/cJ mice were randomized into six tibial nerve transplant groups, including three isograft and three allograft (C57BL/6J) groups. Grafts were left untreated (groups I and II), treated with FK506 (groups III and IV), or treated with rapamycin (groups V and VI). Nerve regeneration was quantified in terms of histomorphometry and functional recovery, and immunosuppression was confirmed with mixed lymphocyte reactivity assays. Animals treated with FK506 and rapamycin were immunosuppressed and demonstrated significantly less immune cell proliferation relative to untreated recipient animals. Although every animal demonstrated some functional recovery during the study, animals receiving an untreated peripheral nerve allograft were slowest to recover. Isografts treated with FK506 but not rapamycin demonstrated significantly increased nerve regeneration. Nerve allografts in animals treated with FK506, and to a lesser extent rapamycin, however, both demonstrated significantly more nerve regeneration and increased nerve fiber widths relative to untreated controls. The authors suggest that rapamycin can facilitate regeneration through peripheral nerve allografts, but it is not a neuroregenerative agent in this in vivo model. Nerve regeneration in FK506-treated peripheral nerve isografts and allografts was superior to that found in rapamycin-treated animals. Rapamycin may have a role in the treatment of peripheral nerve allografts when used in combination with other medications, or in the setting of renal failure that often precludes the use of calcineurin inhibitors such as FK506.