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Scandinavian Journal of Work,... May 2011In response to a request for a medicolegal opinion from an orthopaedic technician with pacinian neuroma of the hand, we conducted a systematic review of reported cases... (Review)
Review
OBJECTIVE
In response to a request for a medicolegal opinion from an orthopaedic technician with pacinian neuroma of the hand, we conducted a systematic review of reported cases designed to assess whether this rare disease could be considered to be work-related.
METHODS
We used Medline, Embase, Google Scholar, Google, and a manual search to identify reports of histologically confirmed pacinian neuroma of the hand manifesting after 15 years of age. Cases with available information (from article/authors) on personal history were considered eligible. We tabulated information on age/gender; localization and histopathologic features; signs/symptoms; history of local trauma; occupation, sports/hobbies or other physical exposures; right- or left-handedness; and outcome.
RESULTS
We found 44 eligible cases (including the present referral). Of these, 21 (48%) followed a trauma [<6 months from onset/presentation (N=7); 0.5-2 years from onset (N=6); ≥ 2 years from onset (N=7); and timing unknown (N=1)] involving the same anatomic site. Three of these 21 traumas definitely occurred at work, and a further 2 cases occurred at the site of definite work-related repetitive microtrauma.
CONCLUSIONS
The results reinforce the concept that pacinian neuroma of the hand can follow local trauma or repetitive microtrauma. Implicated traumas were either recent or remote, and they sometimes occurred while performing manual tasks at work. We concluded that the referred case could plausibly be considered work-related.
Topics: Adult; Cumulative Trauma Disorders; Hand; Humans; Male; Neuroma; Occupational Diseases; Occupational Exposure; Pacinian Corpuscles
PubMed: 21082159
DOI: 10.5271/sjweh.3132 -
The Cochrane Database of Systematic... Feb 2010Glaucoma is a heterogeneous group of conditions involving progressive damage to the optic nerve, deterioration of retinal ganglion cells and ultimately visual field... (Review)
Review
BACKGROUND
Glaucoma is a heterogeneous group of conditions involving progressive damage to the optic nerve, deterioration of retinal ganglion cells and ultimately visual field loss. It is a leading cause of blindness worldwide. Open angle glaucoma (OAG), the commonest form of glaucoma, is a chronic condition that may or may not present with increased intraocular pressure (IOP). Neuroprotection for glaucoma refers to any intervention intended to prevent optic nerve damage or cell death. The treatment can target extracellular factors such as reducing IOP, or cellular factors derived from the optic nerve itself such as blocking intracellular death signals.
OBJECTIVES
The objective of this review was to systematically examine the evidence regarding the effectiveness of neuroprotective agents, either topical or oral, for slowing the progression of OAG in adults.
SEARCH STRATEGY
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library, Issue 4, 2009), MEDLINE (January 1960 to January 2010), EMBASE (January 1980 to January 2010), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to January 2010) and ClinicalTrials.gov (http://clinicaltrials.gov). (5 January 2010). There were no language or date restrictions in the search for trials. The electronic databases were last searched on 5 January 2010.
SELECTION CRITERIA
This review was limited to randomized controlled trials (RCTs) in which topical or oral treatments were used to prevent retinal ganglion cell death. Our population of interest was adults with OAG. As the primary outcome for this review was the proportion of participants who developed any progression of visual field loss at five years post intervention, only trials with at least five years of follow-up were included.
DATA COLLECTION AND ANALYSIS
Two review authors independently reviewed titles and abstracts from the literature searches. Full text copies of relevant or potentially relevant studies were obtained and re-evaluated for inclusion. There were no trials identified for this review, thus we performed no data extraction or meta-analysis. Two studies comparing memantine to placebo are currently awaiting classification until additional study details are provided. Reasons for excluding studies from the review were documented.
MAIN RESULTS
In accordance with the selection criteria for inclusion, we identified no studies relevant for this review. The results of short-term trials and other studies are discussed in this review.
AUTHORS' CONCLUSIONS
Although neuroprotective agents are intended to act as pharmacological antagonists to prevent cell death, the evidence that they are effective in preventing retinal ganglion cell death, and thus preserving vision in patients with OAG, has not been demonstrated. Long-term RCTs are needed to determine whether or not neuroprotective agents may be beneficial for individuals with OAG.
Topics: Administration, Oral; Administration, Topical; Adult; Cell Death; Disease Progression; Glaucoma, Open-Angle; Humans; Neuroprotective Agents; Optic Nerve; Optic Nerve Diseases; Retinal Ganglion Cells
PubMed: 20166085
DOI: 10.1002/14651858.CD006539.pub2 -
Digestion 2004While the regular and symmetric innervation of the pelvic floor has been regarded as "established" for many years, recent data indicate that asymmetry of innervation of... (Review)
Review
UNLABELLED
While the regular and symmetric innervation of the pelvic floor has been regarded as "established" for many years, recent data indicate that asymmetry of innervation of the sphincters may exists and may contribute to the occurrence and severity of incontinence symptoms in case of pelvic floor trauma.
METHODS
A systematic review of published papers on asymmetry of sphincter innervation was performed including studies in healthy volunteers and patients with incontinence. 234 consecutive patients with fecal incontinence were investigated by means of side-separated mass surface EMG from the left and right side anal canal, these data were correlated to clinical and anamnestic findings.
RESULTS
The literature survey indicates that asymmetry of sphincter innervation exists in a subgroup of healthy male and female volunteers, and may be a risk factor to become incontinent in case of trauma. Patients with incontinence in whom asymmetry of sphincter innervation could be shown more frequently reported a history of pelvic floor trauma during childbirth. Childbirth per se but not the number of deliveries predicted sphincter asymmetry. Asymmetrically innervated sphincters show a compromised sphincter function in routine anorectal manometry.
CONCLUSION
Assessment of sphincter innervation asymmetry may be of value in clinical routine testing of patients with incontinence. However, a new technology is needed to replace mass surface EMG by multi-electrode arrays on a sphincter probe. This is one of the goals of the EU-sponsored research project OASIS.
Topics: Electric Stimulation; Electromyography; Fecal Incontinence; Female; Humans; Male; Motor Neurons; Neurons, Afferent; Pelvic Floor; Urinary Incontinence
PubMed: 15087577
DOI: 10.1159/000077876