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Lysosomal Storage Disorders and Enzyme Replacement Therapy
Published in Peter Grunwald, Pharmaceutical Biocatalysis, 2020
Individuals with MPS II grow steadily until about age 5 and develop first features of this disease between ages 2 and 4 (full lips, large rounded cheeks, a broad nose, and an enlarged tongue, and frequent upper respiratory infections, due to airway narrowing). With disease progression nearly all organs and tissues become affected; this leads among others—apart from possible macrocephaly and hydrocephalus—to enlarged liver and spleen (hepatosplenomegaly), and enlarged heart (ventricular hypertrophy) due to heart valve abnormalities that may result in heart failure, too. Carpal tunnel syndrome (CTS) mediated by compression of the median nerve goes along with symptoms like pain, numbness, and tingling in fingers and the hands, and by narrowing the spinal canal the spinal cord becomes damaged (spinal stenosis). MPS II patients may also suffer from reduced vision and may develop hearing loss. Persons with this disease are of short stature (because growth slows beyond age 5), have joint deformities with the consequence of reduced mobility, and dysostosis multiplex which means severe abnormalities in development of skeletal cartilage and bone together with mental retardation. In patients with severe MPS II the disease progresses rapidly with loss of basic functional skills and mental retardation between ages 6 and 8 and the life expectancy is 10 to 20 years (Jones et al., 2009). Individuals with the mild form of MPS II may live into adulthood and their intelligence is not or comparatively slightly affected (Wraith et al., 2008; NIH, 2018, 2018).
Cumulative Trauma
Published in Ronald Scott, of Industrial Hygiene, 2018
There are some simple tests for the onset of carpal tunnel syndrome. One, the Phalen wrist flexor test, involves pressing the backs of the hands together with fingers pointed downward and the arms horizontal. If numbness or tingling appears after a minute, this is a sign the median nerve is under pressure, it is likely that the carpal tunnel is narrowed. In the median nerve percussion test, a person repeatedly taps the inside of the wrist with the fingers of the opposite hand. A tight fit for the median nerve results in nerve stimulation, evidenced by “prickling” in that hand. Neither of these are absolute indicators, and a physician should be consulted when there is any possibility of carpal tunnel problems.
Hand-Transmitted Vibration
Published in Neil J. Mansfield, Human Response to Vibration, 2004
Another type of neurological disorder that is often observed with those who are exposed to vibration is carpal tunnel syndrome (CTS). The carpal tunnel is formed between the bones of the wrist and the transverse carpal ligament through which the flexor tendons and the median nerve pass. If the median nerve is injured, then numbness and loss of feeling and grip can occur. CTS is also common among those who operate all types of tools, and so it is possible that the condition is a hazard of the job in general, rather than a symptom due to vibration itself. This is one example of why it is important to consider all ergonomic risk factors when evaluating a task and not to concentrate on just one aspect of the total problem.
Prevalence and risk factors for self-reported symptoms of carpal tunnel syndrome among hospital office workers: a cross-sectional study
Published in International Journal of Occupational Safety and Ergonomics, 2023
Carpal tunnel syndrome (CTS) occurs as a result of compression of the median nerve in the carpal tunnel at the wrist joint level and is the most common peripheral nerve entrapment disease. CTS is not a simple condition but a serious cause of disability, and is defined as the upper extremity musculoskeletal disease associated with the highest cost among working-age patients in relation to taking sick leave, decreased productivity and personal financial losses [1]. The US Bureau of Labor Statistics reported that all musculoskeletal problems were responsible for an estimated 32.2 cases and an average 12 days off work per 10,000 workers in 2015, in all industries in the USA, while CTS accounted for the highest number of workdays lost (on average, 28 days off work per case) [2]. Early detection of CTS can also be a critical factor affecting the return to work. Workers with a correct and early diagnosis of CTS were found to be much more likely to return to work than workers diagnosed weeks or months later [3].
Women’s wrist and elbow at work: analysis of acute injuries and cumulative trauma disorders to improve ergonomics in female-dominated activities
Published in Ergonomics, 2022
Silvana Salerno, Claudia Giliberti
Many occupations, where the presence of women is predominant, require repetitive movements, often a cause of upper limb occupational disorders, such as epicondylitis, carpal tunnel syndrome, rotator cuff syndrome, supraspinatus tendinopathy, etc. (Bergamasco, Girola, and Colombini 1998; Nordander et al. 2009; Chen et al. 2010; Bonfiglioli, Mattioli, and Violante 2015; Major, Clabault, and Wild 2021). Most studies, involving cases where women were compensated for work-related disorders, concern carpal tunnel syndrome (CTS) and epicondylitis (Lippel 2003; Probst and Salerno 2016). Carpal tunnel syndrome (CTS) refers to the compression of median nerve at the carpal tunnel of the wrist. In most cases, pain, numbness and tingling may extend from the hand up to the arm. Weak grip strength and weakness of the muscles, at the base of the thumb, may persist for a long time. Epicondylitis is another common upper-extremity musculoskeletal disorder among women, especially in the age group 40–60. It involves tendinopathy in which the outer (lateral epicondylitis) or the inside part of the elbow (medial epicondylitis) becomes painful and swollen. In the general population, the prevalence of lateral epicondylitis is higher than medial epicondylitis and both are more frequent among women, as confirmed in medical consultations (Shiri and Viikari-Juntura 2011; Lee et al. 2016). Pain may extend into the back of the forearm and grip strength may also be weakened, determining an impaired function.
Cross-sectional changes of the distal carpal tunnel with simulated carpal bone rotation
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Carpal tunnel syndrome is a peripheral nerve entrapment syndrome affecting a large portion of the general (Atroshi et al. 1999) and working populations (Dale et al. 2013; Luckhaupt et al. 2013). The most common treatment for carpal tunnel syndrome is to undergo carpal tunnel release surgery, whereby pressure at the median nerve is relieved by transecting the transverse carpal ligament (TCL) (Badger et al. 2008; Rodner and Katarincic 2008). Regarding various patient outcome measurables, surgical treatment shows preferred results, as compared to those for therapeutic options such as splinting (Gerritsen et al. 2002), non-steroidal anti-inflammatory drugs (Jarvik et al. 2009) and steroid injections (Hui et al. 2005). Although surgery is more effective, the invasive nature of the procedure does present the risk of complications, albeit rare (Karl et al. 2016). Such risks are minimal with noninvasive physical therapeutics. These options, which can include splinting (Huisstede et al. 2010) and carpal bone mobilization (Huisstede et al. 2010), often involve force application at or near the radiocarpal or midcarpal joint. These force applications are likely to induce relative motion of the carpal bones.