Manual handling of heavy loads and low back pain among different occupational groups: results of the 2018 BIBB/BAuA employment survey.

BACKGROUND: In Germany and other European countries, many occupations still involve manual handling of loads (MHL), an activity that puts the musculoskeletal system at risk of low back pain (LBP). This study aims to describe the current prevalence of MHL in different occupational groups stratified by gender in Germany, the association between MHL and LBP and the adjusted prevalence of LBP in different respond-categories of MHL. METHODS: Data was collected in telephone interviews conducted as part of the 2018 BIBB/BAuA Employment Survey, which covers work-related topics like working conditions, education, health status and job satisfaction. The analyses were limited to full-time workers (> 35 h/week) aged between 15 and 67. The frequency of MHL was analysed descriptively. BLOSSFELD classification was used to group the participants in occupational categories. The analysis of the association between MHL and the prevalence of LBP over the last 12 months was based on robust log-linear Poisson regression that results in prevalence ratios (PR). The main regression model was adjusted for gender, age, working hours, and working conditions. Adjusted estimates for the prevalence of LBP were calculated based on regression analysis. RESULTS: The sample consists of n = 14,331 participants (men: n = 8828, 61.6%; women: n = 5503, 38.4%; median age 49 years). Of these, 52.8% say they were exposed to MHL at work. MHL is most common in agricultural occupations, skilled and unskilled occupations. In the regression model, participants who said they were "often" exposed to MHL reported more frequently LBP than those participants who said they were "never" exposed to MHL. The PR as estimate for the association is 1.41 (95%CI [1.32; 1.49]). Postestimation of the prevalence of LBP began with 47.3% (95%CI [43.8%; 51.1%]) for participants who said they were "never" exposed to MHL and rose to 66.5% (95%CI [62.4%; 71.0%]) for participants who indicated they were "often" exposed to MHL. CONCLUSIONS: The 2018 BIBB/BAuA Employment Survey emphasizes that MHL is still common in the German workforce and shows a significant association to LBP. Prevention policies for avoiding MHL remain vital.

MTHFR (methylenetetrahydrofolate reductase: EC 1.5.1.20) SNPs (single-nucleotide polymorphisms) and homocysteine in patients referred for investigation of fertility.

PURPOSE: MTHFR, one of the major enzymes in the folate cycle, is known to acquire single-nucleotide polymorphisms that significantly reduce its activity, resulting in an increase in circulating homocysteine. Methylation processes are of crucial importance in gametogenesis, involved in the regulation of imprinting and epigenetic tags on DNA and histones. We have retrospectively assessed the prevalence of MTHFR SNPs in a population consulting for infertility according to gender and studied the impact of the mutations on circulating homocysteine levels. METHODS: More than 2900 patients having suffered at least two miscarriages (2 to 9) or two failed IVF/ICSI (2 to 10) attempts were included for analysis of MTHFR SNPs C677T and A1298C. Serum homocysteine levels were measured simultaneously. RESULTS: We observed no difference in the prevalence of different genetic backgrounds between men and women; only 15% of the patients were found to be wild type. More than 40% of the patients are either homozygous for one SNP or compound heterozygous carriers. As expected, the C677T SNP shows the greatest adverse effect on homocysteine accumulation. The impact of MTHFR SNPs on circulating homocysteine is different in men than in women. CONCLUSIONS: Determination of MTHFR SNPs in both men and women must be seriously advocated in the presence of long-standing infertility; male gametes, from MTHFR SNPs carriers, are not exempted from exerting a hazardous impact on fertility. Patients should be informed of the pleiotropic medical implications of these SNPs for their own health, as well as for the health of future children.

Giant Extracranial Meningioma Associated With Hormonal Imbalances Due to Thyroidectomy: Case Report and Literature Review.

Meningiomas represent a prevalent class of primary brain tumors, with malignancies such as World Health Organization grade III meningiomas posing significant clinical challenges due to their aggressive nature and potential for recurrence. This case report showcases the clinical journey of a 67-year-old female patient presenting with a giant malignant meningioma post-thyroidectomy, who unfortunately succumbed to postoperative complications. The report offers a comprehensive analysis of the tumor's clinical presentation, including its substantial size, which qualifies it as a 'giant' meningioma, and explores the patient's endocrine dysfunction as a possible contributing factor to her neurological pathology. In the broader context of meningioma management, the report synthesizes data from multiple studies, underscoring the higher incidence of such malignancies in post-pubertal women and the complexity of treatment modalities. Surgical resection remains the cornerstone of treatment, especially when combined with adjuvant therapies. The report concludes with a discussion on the persistent gaps in knowledge regarding the pathogenesis of giant malignant meningiomas and the need for further research, particularly concerning the role of endocrine dysregulation in their development. This case underscores the imperative for multidisciplinary approaches and individualized treatment strategies in the management of malignant meningiomas, with an emphasis on the intricate interplay between endocrine factors and tumor progression.