Prevalence of and risk factors for low back pain among dentists.

[Purpose] The purpose of this study was to determine the prevalence, symptoms of, and risk factors for low back pain among dentists as well as to discover the possible correlation of these factors with working posture and how to reduce their prevalence. [Subjects and Methods] The study was conducted among 60 dentists (28 male and 32 female) with a mean age of 25.7 years. Dentists were evaluated with the self-administered Nordic musculoskeletal evaluation chart, postural discomfort chart, and a self-prepared questionnaire. [Results] The data showed a 70% incidence of back pain among dentists, with low back pain predominating in 47.6% of cases. Most of the subjects (90.5%) had a mild-to-moderate level of severity, and only 9.5% had a severe level of low back pain. The majority of the dentists (57%) treated 1-3 patients per day. Only a few dentists (17%) exercised during their rest period even though 57% of them reported taking a break during their working hours. Although 63% of the dentists were aware of the advantages of assistive tools, only 40% of them used any kind of assistive devices. [Conclusion] Dental professionals demonstrate a high prevalence of low back pain.

Controlling dyspnea in chronic obstructive pulmonary disease patients.

BACKGROUND: Dyspnea and fatigue are the most mutual symptoms known to be present in chronic obstructive pulmonary disease (COPD) patients. COPD patients have extra trouble breathing out fully. They can apply relaxed breathing techniques any time taking a breath such as following coughing or physical activity. By training to preserve energy with daily chores, patients can perform many physical actions with less dyspnea. AIM: The aim of the current study was to assess the effect of an educational intervention on knowledge, practices, and disease severity in patients with COPD. PARTICIPANTS AND METHODS: A purposive sample of 100 adult male patients was selected randomly from the Respiratory Clinic at King Abdul-Aziz University Hospital, Jeddah. Patients were assessed using a clinical sheet, patients' dyspnea knowledge questionnaire, patients' practices observational checklists, the Modified Borg Scale, and the Hospital Anxiety and Depression Scale. RESULTS: More than 50% of patients had insufficient knowledge and 100% of them reported that they did not practice respiratory muscles exercises before the educational intervention. These improved after the intervention, showing a highly statistically significant difference. In addition, dyspnea and anxiety improved in COPD patients who had received supervised guidelines. CONCLUSION AND RECOMMENDATIONS: Application of dyspnea-management guidelines has enhanced patients' knowledge of their disease, practice, as well as dyspnea and anxiety levels. Health instruction materials for COPD patients can be useful by means of providing simplified guidelines, explanatory videos, leaflets, and/or brochures to clarify, avoid, and manage dyspnea. An additional estimate of the outcome of instructions to avoid and improve dyspnea and distress reactions in a larger sample size is proposed.

How to calculate clearance of highly protein-bound drugs during continuous venovenous hemofiltration demonstrated with flucloxacillin.

BACKGROUND: Flucloxacillin is an important antimicrobial drug in the treatment of infections with Staphylococcus aureus and therefore is often used in staphylococcal infections. Furthermore, flucloxacillin has a high protein binding rate as for example ceftriaxone or teicoplanin--drugs which have formerly been characterized as not being dialyzable. METHODS: The pharmacokinetic parameters of 4.0 g flucloxacillin every 8 h were examined in 10 intensive care patients during continuous venovenous hemofiltration (CVVH) using a polyamide capillary hemofilter. In addition, the difficulty of calculating the hemofiltration clearance of a highly protein-bound drug is described. RESULTS: Flucloxacillin serum levels were significantly lowered (56.9 +/- 24.0%) even though only 15% of the drug was detected in the ultrafiltrate. Elimination half-life, total body clearance and sieving coefficient were 4.9 +/- 0.7 h, 117.2 +/- 79.1 ml/min and 0.21 +/- 0.09, respectively. These discrepancies can be explained by the high protein binding of flucloxacillin, the adsorbing property of polyamide and the equation in order to calculate hemofiltration clearance. The unbound fraction of a 4.0 g flucloxacillin dosage facilitates time above the minimum inhibitory concentration (T > MIC) of 60% only for strains up to a minimum inhibitory concentration (MIC) of 0.5 mg/l. CONCLUSION: Based on the data of this study, we conclude that intensive care patients with staphylococcal infections on CVVH should be treated with 4.0 g flucloxacillin every 8 h which was safe and well tolerated. Moreover, further studies with highly protein-bound drugs are recommended to check the classical 'hemodialysis' equation as the standard equation in calculating the CVVH clearance of highly protein-bound drugs.