RESUMO
Plasmacytomas are malignant tumors characterized by abnormal monoclonal proliferation of plasma cells. They originate either from bone or soft tissue and could be primary or a part of a systemic process during the course of multiple myeloma. Extramedullary plasmacytomas (EPs) in the sinonasal tract or nasopharynx are rare and mostly presented as case reports. We describe a unique case of multiple myeloma involving the nasal cavity and the paranasal sinuses with osteolytic expansile lesions of the first cervical vertebrae (atlas), the clavicle, and the skull in a 51-year-old man. The diagnostic approach was challenging, and finally the biopsy of the extramedullary tumor settled the diagnosis of multiple myeloma. The patient underwent posterior occipitocervical fusion due to upper cervical spine instability due to atlas osteolysis. The patient had an uneventful recovery, and he was finally referred to the hematology department. EP of the nasal cavity is a rare entity and requires a high index of suspicion. EP should be included in the differential diagnoses of nasal cavity masses, especially in males in the age group of 50-60 years. A thorough clinical history, examination, and proper laboratory and radiological investigations are important to settle an accurate diagnosis to initiate treatment as soon as possible. Timely diagnosis ensures a better prognosis and deters the progression of the disease.
RESUMO
AIM: To investigate the disability due to musculoskeletal disorders of the upper extremities in heavy industry workers. METHODS: The population under study consisted of 802 employees, both white- and blue-collar, working in a shipyard industry in Athens, Greece. Data were collected through the distribution of questionnaires and the recording of individual and job-related characteristics during the period 2006-2009. The questionnaires used were the Quick Disabilities of the Arm, Shoulder and Hand (QD) Outcome Measure, the Work Ability Index (WAI) and the Short-Form-36 (SF-36) Health Survey. The QD was divided into three parameters - movement restrictions in everyday activities, work and sports/music activities - and the SF-36 into two items, physical and emotional. Multiple linear regression analysis was performed by means of the SPSS v.22 for Windows Statistical Package. RESULTS: The answers given by the participants for the QD did not reveal great discomfort regarding the execution of manual tasks, with the majority of the participants scoring under 5%, meaning no disability. After conducting multiple linear regression, age revealed a positive association with the parameter of restrictions in everyday activities (b = 0.64, P = 0.000). Basic education showed a statistically significant association regarding restrictions during leisure activities, with b = 2.140 (P = 0.029) for compulsory education graduates. WAI's final score displayed negative charging in the regression analysis of all three parameters, with b = -0.142 (P = 0.0), b = -0.099 (P = 0.055) and b = -0.376 (P = 0.001) respectively, while the physical and emotional components of SF-36 associated with movement restrictions only in daily activities and work. The participants' specialty made no statistically significant associations with any of the three parameters of the QD. CONCLUSION: Increased musculoskeletal disorders of the upper extremity are associated with older age, lower basic education and physical and mental/emotional health and reduced working ability.
