Common risk factors seen in secondary carpal tunnel surgery.

BACKGROUND: We hypothesized that there are several common risk factors associated with secondary carpal tunnel releases. Therefore, we chose to investigate these common factors by analyzing the charts of those patients requiring a second carpal tunnel release (CTR) procedure. METHODS: A retrospective chart review was performed, and patients were identified by searching hospital medical record databases using the Common Procedural Terminology. RESULTS: Between January 1, 2000, and March 31, 2004, 2357 patients had a primary CTR, and 48 of them were found to have had a secondary CTR (of these 48, 9 had diabetes mellitus, 11 had hypertension, and 6 had gastrointestinal-related illnesses). Seven percent of those who had an open release primarily required a second CTR, while only 0.2% of those who had an endoscopic release primarily required a second CTR. CONCLUSION: A greater number of secondary CTR procedures were required for those patients with symptoms of carpal tunnel syndrome in the group that had an open release primarily versus those that had an endoscopic release primarily. Diabetes mellitus and hypertension may also contribute to the need for secondary surgery.

A survey of vitamin A and D contents of fortified fluid milk in Ontario.

High performance liquid chromatographic methods for measuring the concentration of vitamins A and D in fluid milk were validated and used to assess the level of these nutrients in Ontario retail milk samples. Thirteen and fifteen fortified milk samples were tested for vitamins A and D, respectively. Repeatability relative standard deviation values for vitamins A and D in milk were generally less than 10%. Recoveries varied from 87 to 107%. Vitamin D results indicated that only 20% of skim, 40% of 2% fat milk, and 20% of whole milk contained the recommended levels, whereas 46% of skim, and 77% of 2% fat milk had the required levels of vitamin A. The results indicate that vitamin level varies widely in Ontario retail milk.

Health promotion communications system: a model for a dispersed population.

1. Corporations with geographically dispersed populations need to provide flexible health promotion programs tailored to meet specific employee interests and needs. 2. Bell Atlantic developed a dispersed model approach based on the transtheoretical model of behavior change. The key to this model is to identify at which stage the individual is operating and provide appropriate information and behavior change programs. 3. Components of the program include: health risk appraisal; exercise/activity tracking system; on line nurse health information service; network of fitness facilities; employee assistance programs; health library available by fax; health film library; network of health promotion volunteers; and targeted health and marketing messaged via corporate media.

Providing health promotion to a dispersed population.

Health promotion in the 1990s and beyond needs to be flexible, designed for specific populations based on needs assessment, and available to participants at the time of need. The program also must be continuously evaluated and updated as the needs of the participants and corporation change.