Navegando por Palavras-chave "distúrbios osteomusculares relacionados ao trabalho"
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- ItemSomente MetadadadosAfastamentos dos servidores de uma Universidade federal no período de dez anos: análise do resultado das pericias em pacientes com diagnóstico de ler/dort(Universidade Federal de São Paulo (UNIFESP), 2013-11-27) Matsushigue, Thais [UNIFESP]; Belloti, Joao Carlos Belloti [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Context and Objective: The national and international literature have studies linking absenteeism with the existence of musculoskeletal diseases and occupational risks, but without a focus on the outcomes of the absences due to these diseases, which is th
- ItemSomente MetadadadosAfastamentos dos servidores de uma Universidade federal no período de dez anos: análise do resultado das pericias em pacientes com diagnóstico de ler/dort(Universidade Federal de São Paulo (UNIFESP), 2013-11-27) Matsushigue, Thais [UNIFESP]; Belloti, Joao Carlos Belloti [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Context and Objective: The national and international literature have studies linking absenteeism with the existence of musculoskeletal diseases and occupational risks, but without a focus on the outcomes of the absences due to these diseases, which is the goal of this study. Design and setting: This is a historical cohort of federal employees from a university (Universidade Federal de São Paulo - UNIFESP-EPM) Methods: We analyzed medical records of servers absent by a minimum of 30 days and analyzed data including age, gender, time of absence, diagnosis and outcome of removal (sick leave, return to activity, activity change and retirement) Results: We evaluated a total of 7573 events and 1792 were included in the category M of ICD-10 and 5781 in the other categories. Retirement for ICD-10 M (45,2%) was higher than the other diagnoses (27.6%) being the main type because of disability (22.6%), followed by years of service (16.4%) and proportional (6.2%) with p <0.001. The time off also was statistically higher in the M class ICD-10 (41,2%) compared to the other classes (36.8%). Conclusions: Our study showed a higher rate of retirements, as well as higher rate of absence, and longer time of absence in employees diagnosed with musculoskeletal disorders, justifying clinical studies aiming the realization of preventive interventions in occupational health
- ItemAcesso aberto (Open Access)Equívocos diagnósticos envolvendo as tendinites: impacto médico, social, jurídico e econômico(Sociedade Brasileira de Reumatologia, 2009-12-01) Siena, Cesar; Helfenstein Junior, Milton [UNIFESP]; Justiça Federal da 3ª região; Universidade Federal de São Paulo (UNIFESP)Evidence of the clinical, social, and economic impact of mistaken diagnoses of tendonitis and other chronic painful disorders are analyzed. The objective of this review is to call attention to the possible diagnostic hyper valuation of tendonitis, especially those supposedly multiple or refractory, based on evidence. A review of the literature on chronic painful disorders, such as fibromyalgia, in the context of mistaken diagnosis of tendonitis, as well a review of false positive and ultrasonographic (US) scan diagnostic parameters, is presented. Evidence of therapeutic mistakes were found in 41% and diagnostic mistakes in 70 to 85% of the cases, with proven unpreparedness regarding those disorders in up to 93.7% of the physicians. The diverse repercussions of this epidemic of mistakes are discussed.
- ItemAcesso aberto (Open Access)Fibromialgia, LER, entre outras confusões diagnósticas(Sociedade Brasileira de Reumatologia, 2006-02-01) Helfenstein Junior, Milton [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)This is a typical case, extremely common on daily practice, occuring in several areas of our country, involving a young female patient, active professionally, deviated from her job for several years, arguing total lack of efficacy on her treatment, conversely to scientific evidence. She complains of diffuse pain, erroneously interpreted as consequence of her job, with multiple specific diagnosis of musculoskeletal lesions, which has becoming worse, despite of withdrawal of the incriminated biomechanical overloading. The case was interpreted as a disease, lato sensu, which is not recognized in the medical literature. The possibility of fibromyalgia, psicogenic rheumatism and simulation, involving litigation, is brought foward.
- ItemAcesso aberto (Open Access)O ombro em uma linha de produção: estudo clínico e ultrassonográfico(Sociedade Brasileira de Reumatologia, 2009-08-01) Maeda, Ernesto Youiti [UNIFESP]; Helfenstein Junior, Milton [UNIFESP]; Ascencio, João Eduardo Barile; Pollak, Daniel Feldman [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)INTRODUCTION: The correlation among shoulder pain, abnormal physical examination and ultrasonography is controversial in the occupational scenario. OBJECTIVE: Establish the association between pain, physical examination and ultrasounds in workers of a pharmaceutical industry. PATIENTS AND METHODS: One hundred workers were invited to take part in the study and submitted to the inclusion and exclusion criteria, and 93 were included. All enrolled patients gave written informed consent, and had a physical examination performed by one of the authors. Ultrasound examination was performed, at the latest one month of the physical examination, by an experienced operator who was blind to the clinical setting. RESULTS: There was statistical correlation between pain and clinical maneuvers in 57 shoulders for supraspinatus tendon (SE) (P = 0,000) and no correlation with biceps tendon maneuvers (P > 0,05). In the comparison between clinical findings and ultrasonography, the maneuvers of Neer, Hawkins and Jobe had statistical association (P < 0,05). The association between pain and altered ultrasonography was statistically significant (16 among 57 individuals with pain, with P < 0,05), but there was significant false-positive ultrasound findings in asymptomatic shoulders (7 individuals). CONCLUSION: The precise diagnosis is a complex process, which requires the association of clinical and occupational anamnesis, accurate physical examination and ultrasonography performed by an experienced operator.