Direct observation of computer workplace risk factors of college students.

Recently, researchers have reported high musculoskeletal symptom prevalence at several US colleges. Since ergonomic interventions have been shown to prevent and reduce disability, it is important to identify the risk factors for developing symptoms among college students. A nested case-control study was completed to determine computer-related ergonomic risks associated with musculoskeletal symptoms. A trained observer completed ergonomic assessments on 52 randomly selected cases and controls. More than 75 percent (cases and controls combined) of the population was exposed to nine potential postural strains including: arms not along side during keying or mousing; lower back not supported; not having chair accessories; computer monitor not adjustable; mouse being too high or low; hand/wrist/forearm in contact with the desk edge; lack of wrist support; and keyboard not being adjustable. Cases and controls were equally likely to have substantially elevated risks but because the sample was small and lacked power, no risks were statistically significant. Since many known risk factors were prevalent in cases and controls, more research is required to evaluate and prevent injury in this population.

Complete embolization of a left atrial myxoma resulting in acute lower extremity ischemia.

Atrial myxoma is the most common benign tumor of the heart. Patients who have atrial myoxmas usually present with cardiac obstruction, arrhythmias, or peripheral embolization. A tumor originating in the left atrium most often embolizes to the cerebrovascular system. Complete myxoma embolization to the peripheral vessels is rare and usually occurs with tragic consequences. We present an unusual case of acute lower extremity ischemia due to the complete embolization of a left atrial myxoma.

Development of the CLASI as a tool to measure disease severity and responsiveness to therapy in cutaneous lupus erythematosus.

OBJECTIVE: To determine how to use the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) to classify patients according to disease severity (mild, moderate, and severe) and to identify which patients respond to therapy. DESIGN: Cohort. SETTING: The connective-tissue disease clinic at the Hospital of the University of Pennsylvania, Philadelphia. PATIENTS: Seventy-five patients with clinical or histopathologic evidence of cutaneous lupus erythematosus or systemic lupus erythematosus were included in the study. MAIN OUTCOME MEASURES: The CLASI, Skindex-29, and the physician's subjective assessment of severity and improvement were completed at every visit. RESULTS: Disease severity was assessed with 45 patient visits. Mild, moderate, and severe disease corresponded with CLASI activity score ranges of 0 to 9, 10 to 20, and 21 to 70, respectively. Improvement in disease activity was assessed in 74 patients. A clinical improvement was associated with a mean 3-point or 18% decrease in the CLASI activity score. However, receiver operating characteristic analysis demonstrated an increased percentage of patients correctly classified when a 4-point (sensitivity, 39%; specificity, 93%; correctly classified, 76%) or 20% (sensitivity, 46%; specificity, 78%; correctly classified, 67%) decrease in the CLASI activity score was used instead to identify improvement. CONCLUSION: The CLASI can be used to classify patients into groups according to disease severity and to identify clinically significant improvements in disease activity.