The influence of long-term shoulder loading on sagittal spino-pelvic morphology: a population-based retrospective study of Chinese farmers from radiology.

BACKGROUND: To investigate associations between long-term shoulder loading and sagittal spino-pelvic morphology in Chinese farmers from radiology evidences. METHODS: We retrospectively analyzed 463 back pain patients who attended outpatient and inpatient departments of two hospitals from January 2016 to December 2018, and who had long, standing lateral X-rays according to inclusion and exclusion criteria. One hundred eighty-four of them were farmers with a long history of heavy shoulder loading for over 20 years in their young age, while others were office workers with no reported long-term shoulder loading history. The following parameters were measured by three researchers independently and then analyzed statistically: thoracic kyphosis (TK), lumbar lordosis (LL), thoracolumbar kyphosis (TLK), T9 sagittal offset (T9SO), T1 sagittal offset (T1SO), sacral slope (SS), pelvic incidence (PI), pelvic tilt (PT), C7 tilt (C7T), spino-pelvic angle (SSA), and sagittal vertical axis (SVA). RESULTS: The "Loading group" included 86 males and 98 females with average age 73.3 (SD 8.3) years, whereas the "Non-loading group" included 126 males and 153 females with average age 63.7 (SD 14.1) years. Age was significantly higher in the loading group (p < 0.001), but gender, height, weight, BMI, and BMD were not significantly different (p > 0.05). The following spino-pelvic parameters were significantly greater (p < 0.05) in the loading group: TK (mean 39.1° vs 32.8°), TLK (25.8° vs 10.1°), and T9SO (12.2° vs 10.1°). Other values were not significantly different between the two groups (p > 0.05). CONCLUSION: Long-term shoulder loading in youth is a risk factor for pathological thoracic kyphosis especially in the lower thoracic spinal segments when farmers getting older.

Chronic Madura foot: mycetoma and/or Actinomyces spp or actinomycosis.

A 58-year-old agricultural worker from a remote Western province farming community in Saudi Arabia presented with a 2-year history of right plantar foot soft tissue mass. According to the patient, the swelling had gradually increased in size over a few years, but it was painless and thus had not restricted him from continuing to farm until the lesion started to affect mobility. An MRI, microbiology and histopathology reported a rare infectious agent-Actinomyces spp, otherwise referred to as Madura foot. Three-dimensional CT aided in a preoperative surgical plan which included mass excision/debulking for this challenging lesion. Full eradication was not possible, and the patient required prolonged anti-infective therapy (>6 months) along with close surveillance to map resolution of infective symptoms.

Treatment of capitellar osteochondritis dissecans with a tendon graft: a case report.

A 14-year-old girl who was engaged in farming was admitted with the complaints of right elbow pain and limited range of motion in the elbow joint. Plain radiograph revealed capitellar osteochondritis dissecans. After the loose fragment was removed from the capitellum and the defect was curetted, a palmaris longus tendon graft harvested from the same hand was implanted into the capitellar defect. Elbow joint was immobilized for three weeks. Magnetic resonance imaging showed that tendon graft was successfully adapted into defect. The range of motion was preserved and she had no pain in the elbow joint. In conclusion, we suggest that tendon autograft can be used in the treatment of capitellar osteochondritis dissecans.

[Chronic parkinsonian syndrome after 10 years of repeated insecticide spraying]. / Syndrome parkinsonien chronique chez un homme exposé pendant dix ans à des pulvérisations d'insecticides.

INTRODUCTION: Acute and reversible parkinsonism is usually described after massive ingestion of organophosphate insecticides whereas acute intoxications occurring after pesticide spraying are rare. CASE REPORT: We report one case of atypical parkinsonian disorder following repeated spraying with an aerosol insecticide containing pyrethre and organophosphate. This patient had a daily massive dermal and respiratory exposure to these pesticides for 10 years. Cerebral MRI was normal. DAT-scan showed a presynaptic loss of function. CONCLUSION: Pesticides are suspected to be one risk factor responsible for parkinsonism. The present case supports this environmental hypothesis.

Hypersensitivity pneumonitis induced by spores of Penicillium citrinum in a worker cultivating Enoki mushroom.

A 47-year-old Japanese woman was admitted to our hospital with a 2-week history of dry cough and shortness of breath. She had been engaged in Enoki mushroom production for 22 years. Chest X-ray and chest computed tomography (CT) scan showed bilateral fine-nodular shadows and ground glass opacity. Bronchoalveolar lavage fluid demonstrated an increase of total cell counts with predominant lymphocytosis. Pathological specimens obtained by video-assisted thoracoscopic surgery revealed alveolitis and noncaseating granuloma with giant cells. Lymphocyte stimulation test showed positive responses with Enoki mushroom, culture medium, and Penicillium citrinum. On double immunodiffusion test, a precipitation line was observed between patient's serum and Penicillium citrinum antigen. She was found to have hypersensitivity pneumonitis caused by Penicillium citrinum. This is the first report of mushroom worker's lung caused by Penicillium citrinum.

Clinical and radiological prevalence of skeletal fluorosis among retired employees of Wonji-Shoa sugar estate in Ethiopia.

OBJECTIVE: To study the clinical and radiological prevalence of skeletal fluorosis among the retired employees of Wonji-Shoa sugar estate. DESIGN: Retrospective and cross-sectional study. SETTING: Wonji-Shoa sugar estate, an agro-industrial estate located in the Ethiopian Rift Valley. SUBJECTS: Two hundred and sixty three employees of the estate who retired between 1995 and 1996. MAIN OUTCOME MEASURES: Clinical evidence of impaired squatting, neck and lumbar mobility, kyphosis, and X-ray evidence of fluorosis. RESULTS: Skeletal fluorosis was more evident among the males (p<0.05), and the prevalence was higher among the factory and the agricultural workers than among the administrative workers (p<0.05). Clinical prevalence was 20% versus the radiological prevalence of 70.3%, indicating that many cases were asymptomatic. Impaired neck and lumbar mobility and impaired squatting significantly agreed with the radiological diagnosis (p<0.05) while kyphosis was not. CONCLUSION: Further clinical and epidemiological studies are suggested and strengthening of the existing defluoridation programmes within the area is recommended.

Use of ultrasound in occupational risk assessment of low-back pain.

The aim of the study was to evaluate ultrasound technique in preemployment medical assessment of the risk for low-back pain. Volunteers for the study were recruited among agricultural workers employed in the "Agraria Department" of the University of Bologna, Italy. The group consisted of 90 subjects, 52 male and 38 female, aged 25 to 58 years. The subjects filled in a questionnaire on medical history of low-back pain and were examined using an ultrasonograph equipped with a high linear frequency probe (3.5 MHz). The oblique parasagittal diameter of the lumbar spinal canal was measured by transabdominal ultrasonic imaging in the lumbar (L4-L5) and lumbosacral (L5-S1) region. Individuals with significantly narrower canals (< 14 mm) had an increased risk of low-back pain. The paper concludes that ultrasound imaging could become a valuable screening tool in industry, permitting selective job placement for workers at high risk for disorders of the back.

Allergic alveolitis among agricultural workers in eastern Poland: a study of twenty cases.

The aim of this study was to identify the specific agents which caused extrinsic allergic alveolitis (EAA) in the selected group of 20 agricultural workers from eastern Poland. The microbiological analysis of the samples of plant materials or dusts reported by the patients as causing symptoms has been carried out, followed by allergological tests (inhalation challenge, agar-gel precipitation test, inhibition of leukocyte migration, skin test) with extrinsic microbial antigens. It was found that the causative agents of allergic alveolitis in the examined group of patients were mesophilic, non-branching bacteria associated with grain dust, mostly Pantoea agglomerans (synonyms: Erwinia herbicola, Enterobacter agglomerans) and Arthrobacter globiformis (each in eight cases). The remaining agents were Alcaligenes faecalis (in two cases), and Brevibacterium linens and Staphylococcus epidermidis (in one case each). On the basis of the clinical picture, the bronchoalveolar lavage (BAL) and allergological tests, the diagnosis of the chronic form of the disease was stated in 14 patients and an acute form - in 6 patients. EAA patients demonstrated in the BAL fluid a typical lymphocytic alveolitis both in terms of percentage and absolute number of lymphocytes. Also, the numbers of eosinophils and neutrophils were significantly higher in EAA patients.

Coxarthrosis and farm work: a case-referent study.

The purpose of this case-referent study was to analyze the association between coxarthrosis and occupation. The study was performed in a Swedish agricultural county and comprised 269 cases of radiologically verified arthrosis of osteoarthritis (< 3 mm joint space) that were compared to 538 randomly selected controls in the same region, matched for age, sex, and place of residence. Farmers and agricultural workers showed an increased risk of coxarthrosis and the observed risk increased with increasing number of years of farming. Tractor driving and milking were associated with coxarthrosis, whereas no association with other types of machine work could be demonstrated. An association between coxarthrosis and heavy physical work before the age of 16 years was also observed. The results give only limited information on the external causes of coxarthrosis, however. More detailed studies of groups of individuals with coxarthrosis in order to obtain more information about contributing and underlying factors would therefore be valuable.

Morbidity due to Schistosoma mansoni among sugar-cane cutters in Zimbabwe.

Quantitative determination of Schistosoma mansoni infection was carried out on 1995 cane cutters of the Hippo Valley and Triangle Sugar Estates. A total of 315 cutters were chosen for the study on the basis of S. mansoni infection and lack of anti-schistosomal chemotherapy during the previous three years. Stool consistency and blood and mucus in stool were determined for all the infected cutters. Overt and occult blood in stool was detected in a significantly high number of infected people compared to the control subjects (chi 2 p less than 0.001). However, the blood loss was found to have no anaemia-producing effect as determined by haemoglobin and red blood cell counts. Watery stool was prevalent among people with egg output exceeding 500 eggs per gram of stool. Mucus in stool was found to be more prevalent among infected people compared to the control subjects but the difference was not significant (p greater than 0.05). Symmer's periportal fibrosis (PPF) of various degrees of severity was detected in 47% of the infected people and grade one liver fibrosis was found in 7.5% of the control subjects (p less than 0.0001). Some 54.5% of those infected complained of abdominal pains compared to 35% of uninfected controls (p less than 0.01). There was a significant difference in the rate of absenteeism from work due to abdominal pains and diarrhoea among the infected and uninfected cane cutters (p less than 0.02).

Agricultural disorders of the lung.

Agricultural workers are at risk for developing many respiratory tract disorders. Crop production disorders include chronic bronchitis, asthma, organic dust toxicity syndrome, chemical poisoning, farmer lung, and silo-filler disease. Livestock production disorders include toxic manure poisoning (dung lung) and several zoonoses. Radiographic manifestations can be classified into three patterns: (a) normal findings, characteristic of chronic bronchitis, asthma, or organic dust toxicity syndrome; (b) acute diffuse interstitial or alveolar pattern, characteristic of farmer lung, silo-filler disease, dung lung, and chemical poisoning; and (c) chronic interstitial pattern in the upper lobes (farmer lung) or lower lobes (silo-filler disease, paraquat poisoning). Differential diagnosis is aided by knowledge that most of these disorders have a seasonal presentation. Zoonoses generally exhibit focal areas of consolidation in the lung: The type of splenic calcification, presence of mediastinal or hilar adenopathy, and development of bronchiectasis are additional findings useful in differentiating these rare infections.

Mimics of metastases from testicular tumours.

This paper presents 10 patients with a diagnosis of testicular tumour in whom computed tomography (CT) at staging or follow-up demonstrated abnormalities which mimic the appearance of metastatic testicular tumour. The entities mimicking metastases were sarcoidosis, mushroom worker's lung, lymphoma and phaeochromocytoma. Representative examples of these lesions are illustrated and features which may enable the radiologist to differentiate them from metastatic testicular tumour are discussed.

[The tobacco grower's lung: x-ray variants]. / Tabakpflanzer-Lunge: röntgenologische Varianten.

In 143 persons professionally involved with the growing and processing of tobacco roentgenologic lung examinations were carried out. The detected diseases of the respiratory system were classified as exogenous allergic alveolitis (EAA), tobacco growers disease. The proven roentgenologic lung changes were grouped in roentgenologic symptom complexes, that correlate with the clinical variations of the disease (obstructive bronchitis, bronchial asthma, recurring pneumonia).