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https://www.readbyqxmd.com/read/29343286/diagnosis-and-management-of-transthyretin-familial-amyloid-polyneuropathy-in-japan-red-flag-symptom-clusters-and-treatment-algorithm
#1
REVIEW
Yoshiki Sekijima, Mitsuharu Ueda, Haruki Koike, Sonoko Misawa, Tomonori Ishii, Yukio Ando
Hereditary ATTR (ATTRm) amyloidosis (also called transthyretin-type familial amyloid polyneuropathy [ATTR-FAP]) is an autosomal-dominant, adult-onset, rare systemic disorder predominantly characterized by irreversible, progressive, and persistent peripheral nerve damage. TTR gene mutations (e.g. replacement of valine with methionine at position 30 [Val30Met (p.Val50Met)]) lead to destabilization and dissociation of TTR tetramers into variant TTR monomers, which form amyloid fibrils that deposit in peripheral nerves and various organs, giving rise to peripheral and autonomic neuropathy and several non-disease specific symptoms...
January 17, 2018: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/29330689/the-efficiency-of-acoustic-radiation-force-impulse-arfi-elastography-in-the-diagnosis-and-staging-of-carpal-tunnel-syndrome
#2
Harun Arslan, Alpaslan Yavuz, Ferda İlgen, Abdurrahman Aycan, Mesut Ozgokce, Hüseyin Akdeniz, Abdussamet Batur
OBJECTIVES: The aim of the present study was to quantify the stiffness of the median nerve (MN) at the carpal tunnel inlet by acoustic radiation force impulse (ARFI) elastography and to evaluate whether ARFI can be used in diagnosis and staging of carpal tunnel syndrome (CTS). METHODS: Sonographic examinations of 96 wrists in 50 patients were included in the study. The cross-sectional area and stiffness of the MN were quantitatively measured by B-mode ultrasonography (USG) and ARFI...
January 12, 2018: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/29329504/expression-of-vitamin-d-receptor-in-the-subsynovial-connective-tissue-in-women-with-carpal-tunnel-syndrome
#3
Kahyun Kim, Hyun Sik Gong, Jihyeung Kim, Goo Hyun Baek
Studies suggest that low vitamin D levels are associated with carpal tunnel syndrome. We aimed to evaluate whether level of vitamin D receptor expression in the endothelial cells of the subsynovial connective tissue is associated with clinical features of carpal tunnel syndrome. We obtained the subsynovial connective tissue from 52 women with carpal tunnel syndrome during surgery and performed immunohistochemical analysis of vitamin D receptors in the endothelial cells of the subsynovial connective tissue. We explored correlation of vitamin D receptor expression with clinical features of carpal tunnel syndrome, such as age, symptom duration, symptom severity and electrophysiological severity...
January 1, 2018: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29322890/an-analysis-of-the-course-of-carpal-tunnel-syndrome-before-operation
#4
P Puchalski, A Zyluk, P Zyluk-Gadowska
This work reports the results of an analysis into the course of carpal tunnel syndrome before operation in 479 patients, predominantly women, aged a mean of 58 years, who were scheduled for carpal tunnel operation. The patients were asked to characterise in detail the course of the disease and what determined the decision to undergo surgery. RESULTS: We identified two specific patterns of CTS course: progressive and preservative/mild. Patients with short-lasting disease suffer first of all from symptoms, but the longer the duration, the more pronounced the functional impairment...
March 2017: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29322873/trends-and-complications-in-open-versus-endoscopic-carpal-tunnel-release-in-private-payer-and-medicare-patient-populations
#5
Sai K Devana, Andrew R Jensen, Kent T Yamaguchi, Anthony D'Oro, Zorica Buser, Jeffrey C Wang, Frank A Petrigliano, Casimir Dowd
PURPOSE: The purpose of this study was to report trends, complications, and costs associated with endoscopic carpal tunnel release (ECTR) and open carpal tunnel release (OCTR). METHODS: Using Current Procedural Terminology (CPT) and International Classification of Diseases, Ninth Revision (ICD-9) codes, patients who had open versus endoscopic carpal tunnel release (CTR) were identified retrospectively in the PearlDiver database from both the Medicare and Humana (a private payer health insurance) populations from 2005 to 2014...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29321702/carpal-tunnel-syndrome-in-obstructive-sleep-apnea-patients
#6
Özgür Bilgin Topçuoğlu, Özlem Oruç, Sema Saraç, Gülgün Çetintaş Afşar, Kayıhan Uluç
Introduction: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper extremity. It is usually associated with the compression of the median nerve in the median groove. Because the main symptoms of CTS pain and numbness worsen at night, sleep disorders in CTS patients and the impact of preferred sleeping position on CTS development have been formerly studied. However, to the best of our knowledge, this is the first study assessing the frequency of CTS in obstructive sleep apnea (OSA) patients...
December 2017: Noro Psikiyatri Arsivi
https://www.readbyqxmd.com/read/29320842/carpal-tunnel-syndrome-in-hiv-positive-patients-coinfected-with-hcv
#7
A Mastroianni, F Allegrini, S Nardi, D Donatucci, F Girelli, C Guidi
A wide range of rheumatic and peripheral nervous system disorders may develop in patients with HIV infection, leading to pain, sensory symptoms, and muscle weakness. Over the past three decades, the progress in management of HIV disease with anti-retroviral therapy (ART) has resulted in increased life expectancy for people living with HIV disease. With this new chronicity of the disease has a constellation of chronic musculoskeletal, orthopaedic and rheumatic manifestations has emerged, as potential complications of the disease itself and/or the results of ART treatment regimen and/or because of expected age-related symptoms/manifestations...
December 21, 2017: Reumatismo
https://www.readbyqxmd.com/read/29314300/low-grade-fibromyxoid-sarcoma-arising-within-the-median-nerve
#8
Amy A Swanson, Caterina Giannini, Andrew L Folpe, Daniel L Van Dyke, Kimberly K Amrami, William A Michalak, Rachael A Vaubel
We report a case of low-grade fibromyxoid sarcoma arising within the median nerve. A 31-year-old woman presented with symptoms of carpal tunnel syndrome and an enlarging mass in her right palm over 1 year. MRI demonstrated a mass associated with the right median nerve with solid and cystic components. At surgery, the mass was located within the epineurium, could be bluntly dissected from the nerve fascicles, and was suspected to be a schwannoma. A 3.4 cm, tan-pink, glistening, smooth, homogenous mass was submitted to pathology...
January 3, 2018: Neuropathology: Official Journal of the Japanese Society of Neuropathology
https://www.readbyqxmd.com/read/29307812/neurodynamic-techniques-versus-sham-therapy-in-the-treatment-of-carpal-tunnel-syndrome-a-randomized-placebo-controlled-trial
#9
Tomasz Wolny, Paweł Linek
OBJECTIVES: To evaluate the efficacy of neurodynamic techniques used as the sole therapeutic component compared with "sham" therapy in the treatment of mild and moderatecarpal tunnel syndromes (CTS). DESIGN: Single blinded, randomized placebo-controlled trial. SETTING: Several medical clinics in the south of Poland. PARTICIPANTS: Volunteer sample of 150 patients diagnosed with CTS. MAIN OUTCOME MEASURES: Symptom severity (SSS) and Functional status (FSS) of Boston Carpal Tunnel Questionnaire (BCTQ)...
January 4, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29306239/comparing-the-effectiveness-of-ultrasound-guided-versus-blind-steroid-injection-in-the-treatment-of-severe-carpal-tunnel-syndrome
#10
Özgür Zeliha Karaahmet, Eda Gürçay, Murat Kara, Azize Serçe, Zeynep Kıraç Ünal, Aytül Çakcı
Background/aim: This study aimed to compare the effectiveness of ultrasound (US)-guided injection versus blind injection of corticosteroids in the treatment of carpal tunnel syndrome (CTS). Materials and methods: This prospective, randomized clinical trial included patients with severe CTS based on clinical and electrophysiological criteria. The patients were evaluated for clinical and electrophysiological parameters at baseline and 4 weeks after treatment. Symptom severity and hand function were assessed by the Boston questionnaire...
December 19, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29305236/psychological-status-is-associated-with-symptom-severity-in-patients-with-carpal-tunnel-syndrome
#11
Young Ho Shin, Jun O Yoon, You Keun Kim, Jae Kwang Kim
PURPOSE: The purpose of this study was to investigate whether psychological status is associated with symptom severity or functional disability of carpal tunnel syndrome (CTS) patients. PATIENTS AND METHODS: Sixty patients diagnosed with CTS and treated with carpal tunnel release (CTR) were asked to complete a self-administered questionnaire consisting of 3 validated measures obtained before and 3 months after surgery. The Boston Carpal Tunnel Questionnaire (BCTQ) was administered to assess symptoms (BCTQ-S) and functional disabilities (BCTQ-F), and the Center for Epidemiologic Studies Depression Scale (CES-D) and Pain Anxiety Symptoms Scale (PASS) were administered to assess depression and pain anxiety...
January 3, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29302140/neurogenic-edema-from-complex-regional-pain-syndrome-resulting-in-fulminant-infection-necessitating-below-elbow-amputation
#12
Daniel P Carpenter, Reid W Draeger
We report a case of severe upper extremity complex regional pain syndrome type 1 (CRPS-1) and neurogenic edema that ultimately led to a medically necessary below-elbow amputation. The patient presented with a history of remote bilateral carpal tunnel release complicated by debilitating and recalcitrant bilateral CRPS-1. Following years of severe neurogenic edema of the left upper extremity, the patient had full-thickness skin sloughing on the dorsum of her hand due to massive edema. This subsequently led to maggot infestation of the soft tissues of the left hand ultimately necessitating amputation...
December 2017: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/29284161/ultrasound-guided-corticosteroid-injection-in-patients-with-carpal-tunnel-syndrome-efficacy-of-intra-epineurial-injection
#13
Yi-Chih Hsu, Fu-Chi Yang, Hsian-He Hsu, Guo-Shu Huang
PURPOSE:  To identify the ultrasound (US) findings of intra-epineurial corticosteroid injection during US-guided hydrodissection in patients with carpal tunnel syndrome (CTS), and to determine their clinical relevance in relation to treatment outcomes. MATERIALS AND METHODS:  We performed 101 US-guided hydrodissections and corticosteroid injections in 101 patients with CTS, and evaluated their pre- and post-injection US findings. We categorized these injections into two groups based on the occurrence of intra-epineurial injection...
December 28, 2017: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/29282463/prevalence-of-work-related-musculoskeletal-disorders-among-surgeons-and-interventionalists-a-systematic-review-and-meta-analysis
#14
Sherise Epstein, Emily H Sparer, Bao N Tran, Qing Z Ruan, Jack T Dennerlein, Dhruv Singhal, Bernard T Lee
Importance: Physicians in procedural specialties are at high risk for work-related musculoskeletal disorders (MSDs). This has been called "an impending epidemic" in the context of the looming workforce shortage; however, prevalence estimates vary by study. Objectives: To estimate the prevalence of work-related MSDs among at-risk physicians and to evaluate the scope of preventive efforts. Data Sources and Study Selection: Systematic search in MEDLINE (Ovid), Embase (Elsevier), Web of Science, PubMed (National Center for Biotechnology Information), and 2 clinical trial registries, without language restriction, for studies reporting on the prevalence and prevention of work-related MSDs among at-risk physicians published until December 2016...
December 27, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29274661/perioperative-celecoxib-and-postoperative-opioid-use-in-hand-surgery-a-prospective-cohort-study
#15
Jeffrey G Stepan, Daniel A London, Daniel A Osei, Martin I Boyer, Agnes Z Dardas, Ryan P Calfee
PURPOSE: Prescription opioid abuse is an epidemic in the United States; multimodal analgesia has been suggested as a potential solution to decrease postoperative opioid use. The primary aim of this study was to determine the effect of perioperative celecoxib on opioid intake. Secondary goals were to determine whether perioperative administration of celecoxib decreased postoperative patient-reported pain and whether patient demographic characteristics could predict postoperative pain and opioid intake...
December 21, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29239809/influence-of-the-thickness-of-the-transverse-carpal-ligament-in-carpal-tunnel-syndrome
#16
A Bartolomé-Villar, T Pastor-Valero, A Fuentes-Sanz, D Varillas-Delgado, F García-de Lucas
OBJECTIVE: To determine if the thickness of the transverse carpal ligament measured by T2 axial magnetic resonance imaging actually influences the onset of carpal tunnel syndrome. MATERIAL AND METHOD: 94 patients between January 2015 and June 2016, of whom 28 had carpal tunnel syndrome, underwent magnetic resonance imaging, 37 with discomfort in different carpus regions without symptoms of carpal tunnel and 29 healthy subjects. Two observers performed 3 measurements in 3 different levels, and in the 3 groups of patients...
November 24, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29239249/the-association-of-perioperative-glycemic-control-with-postoperative-surgical-site-infection-following-open-carpal-tunnel-release-in-patients-with-diabetes
#17
Brian C Werner, Victor A Teran, Jourdan Cancienne, D Nicole Deal
BACKGROUND: The primary goal of the study was to evaluate the association of hemoglobin A1c (HbA1c) levels in diabetic patients with the incidence of surgical site infection (SSI) following open carpal tunnel release (CTR). Our secondary objective was to calculate an HbA1c level in diabetic patients that predicted SSI after open CTR. METHODS: A national private-payer insurance database was queried for patients who underwent open CTR using Current Procedural Terminology (CPT) code 64721...
December 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29238824/effect-of-perioperative-gabapentin-on-postoperative-pain-resolution-and-opioid-cessation-in-a-mixed-surgical-cohort-a-randomized-clinical-trial
#18
Jennifer Hah, Sean C Mackey, Peter Schmidt, Rebecca McCue, Keith Humphreys, Jodie Trafton, Bradley Efron, Debra Clay, Yasamin Sharifzadeh, Gabriela Ruchelli, Stuart Goodman, James Huddleston, William J Maloney, Frederick M Dirbas, Joseph Shrager, John Costouros, Catherine Curtin, Ian Carroll
Importance: Guidelines recommend using gabapentin to decrease postoperative pain and opioid use, but significant variation exists in clinical practice. Objective: To determine the effect of perioperative gabapentin on remote postoperative time to pain resolution and opioid cessation. Design, Setting, and Participants: A randomized, double-blind, placebo-controlled trial of perioperative gabapentin was conducted at a single-center, tertiary referral teaching hospital...
December 13, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29236827/conservative-therapeutic-management-of-carpal-tunnel-syndrome
#19
Roberto Sérgio Martins, Mário Gilberto Siqueira
Carpal tunnel syndrome is the most prevalent nerve compression and can be clinically or surgically treated. In most cases, the first therapeutic alternative is conservative treatment but there is still much controversy regarding the most effective modality of this treatment. In this study, we critically evaluated the options of conservative treatment for carpal tunnel syndrome, aiming to guide the reader through the conventional options used in this therapy.
November 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/29234455/vibration-thresholds-in-carpal-tunnel-syndrome-assessed-by-multiple-frequency-vibrometry-a-case-control-study
#20
Magnus Flondell, Birgitta Rosén, Gert Andersson, Tommy Schyman, Lars B Dahlin, Anders Björkman
Background: Carpal tunnel syndrome (CTS) is the most common compression neuropathy, but there is no gold standard for establishing the diagnosis. The ability to feel vibrations in the fingertips is dependent on the function in cutaneous receptors and afferent nerves. Our aim was to investigate vibration perception thresholds (VPTs) in patients with CTS using multi-frequency vibrometry. Methods: Sixty-six patients (16 men and 50 women) with CTS, diagnosed from clinical signs and by electroneurography, and 66 matched healthy controls were investigated with multi-frequency vibrometry...
2017: Journal of Occupational Medicine and Toxicology
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