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The utility of nerve conduction studies in patients with diabetic polyneuropathy

100%
Banach M.
Family Medicine & Primary Care Review
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2015
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issue 3
171-174
2
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Personal risk factors for carpal tunnel syndrome in female visual display unit workers

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Riccò M., Cattani S., Signorelli C.
International Journal of Occupational Medicine and Environmental Health
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2016
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vol. 29
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issue 6
927-936
EN
Objectives Carpal tunnel syndrome (CTS) is the most common nerve entrapment syndrome, which since the beginning of the seventies has been linked to the keyboard and visual display unit (VDU). The objective of this study was to investigate the prevalence and personal factors associated with CTS in female VDU workers in Italy. Material and Methods Participants in this study were female adult subjects, working ≥ 20 h/week (N = 631, mean age 38.14±7.81 years, mean working age 12.9±7.24 years). Signs and symptoms were collected during compulsory occupational medical surveillance. The binary logistic regression was used to estimate adjusted odds ratios for the factors of interest. Results Diagnosis of CTS was reported in 48 cases (7.6%, 11 of them or 1.7% after a surgical correction) for the incidence of 5.94/1000 person-years. In general, signs and symptoms of CTS were associated with the following demographic factors: previous trauma of upper limb (adjusted odds ratio (ORa) = 8.093, 95% confidence interval (CI): 2.347–27.904), history (> 5 years) of oral contraceptives therapy/hormone replacement therapy (ORa = 3.77, 95% CI: 1.701–8.354) and cervical spine signs/symptoms (ORa = 4.565, 95% CI: 2.281–9.136). Conclusions The prevalence of CTS was similar to the estimates for the general population of Italy. Among personal risk factors, hormone therapy, previous trauma of the upper limb and signs/symptoms of the cervical spine appeared to be associated with a higher risk of CTS syndrome. Eventually, the results reinforce interpretation of CTS in VDU workers as a work-related musculoskeletal disorder rather than a classical occupational disease. Int J Occup Med Environ Health 2016;29(6):927–936
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Experiences with preventing carpal tunnel syndrome in an automotive plant

75%
Žídková V., Nakládalová M., Zapletalová J., Nakládal Z., Kollárová H.
International Journal of Occupational Medicine and Environmental Health
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2017
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vol. 30
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issue 1
45-54
EN
Objectives Carpal tunnel syndrome (CTS) is a common occupational disease. The aim was to assess the effect of preventive measures in automotive assembly workers. Material and Methods The analysis summarizes data from annual crosssectional studies. The 7-year analysis of data was based on medical records obtained from an occupational physician and inspections carried out at the workplace where targeted preventive measures were introduced, including better ergonomic arrangement of the workplace, technical adjustments facilitating the work, preventive nerve conduction studies (NCS) testing of the median nerve once a year, switching of workers and their targeted rotation within the workplace. The NCS testing of median nerve conduction at the wrist was the basic objective method for assessment of the prevalence and severity of CTS. Over the study period, the sample comprised 1804 workers at risk for repetitive overuse of the upper extremities, of whom 281 were females with a mean age of 38.5 years and 1523 were males with a mean age of 31.4 years. Results Over the study period, a total of 13 cases of CTS were recognized as an occupational disease in the plant, 8 of which occurred within the first 2 years from the initiation of production. Introduction of preventive measures decreased the prevalence of median neuropathy from 18.3% of examined extremities in 2011 to 10.5% in 2013 (p = 0.003). In early 2014, the production pace increased and this was accompanied by a rise in abnormal NCS findings to 16.9%. Over the study period, the rate of sensorimotor neuropathy decreased in favor of merely sensory neuropathies, which have been most frequent since 2013. The percentage of employees whose contracts were terminated due to median neuropathy decreased steadily from 5.5% to 0.4%. Conclusions Targeted prevention of work-related CTS is effective as evidenced by the decrease in the prevalence of median neuropathy detected by NCS. Int J Occup Med Environ Health 2017;30(1):45–54
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Is ulnar nerve entrapment at wrist frequent among patients with carpal tunnel syndrome occupationally exposed to monotype wrist movements?

75%
Lewańska M., Walusiak-Skorupa J.
International Journal of Occupational Medicine and Environmental Health
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2016
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vol. 30
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issue 6
861-874
EN
Objectives Association between carpal tunnel syndrome (CTS) and ulnar nerve entrapment at wrist remains controversial. The aim of the study has been to investigate the prevalence of Guyon’s canal syndrome amongst patients diagnosed with the CTS, occupationally exposed to repetitive wrist movements. Material and Methods The retrospective analysis of 310 patients (268 females, 42 males) representing the mean age of 52±7 years old hospitalized for the suspected occupational CTS was performed. Results In the analyzed cohort, 4 patients had undergone decompression of the Guyon’s canal in the right limbs. Nerve conduction studies (NCS) in the ulnar nerves performed during the hospitalization of those patients did not show any abnormalities. Nerve conduction studies revealed signs of the ulnar neuropathy (UN) at the wrist affecting exclusively sensory fibers for 6 patients. Only those 4 patients who had undergone the operation suffered from clinical symptoms of the UN before the surgery. In the case of the remaining patients, despite the NCS changes, signs suggestive of the UN at the wrist were not detected. In the case of the patients with the occupational CTS, no signs of the ulnar nerve dysfunction were recorded. Conclusions The frequency of ulnar nerve entrapment at the wrist among patients with the CTS is lower than that already reported. The low prevalence of ulnar involvement (3.2%) for the CTS patients in our study may be related to the relatively small number of the CTS hands with the severe changes in the NCS and/or other personal factor including anatomical variation of the Guyon’s canal borders and its contents. Int J Occup Med Environ Health 2017;30(6):861–874
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