scholarly journals Anaphylactic Reactions Caused by Nafamostat Mesylate during Hemodialysis before Surgery for Carpal Tunnel Syndrome

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Yuta Nakamura ◽  
Kaoru Tada ◽  
Masashi Matsuta ◽  
Atsuro Murai ◽  
Hiroyuki Tsuchiya
Keyword(s):  
Blood Pressure ◽  
Carpal Tunnel Syndrome ◽  
Adverse Effects ◽  
Carpal Tunnel ◽  
Disseminated Intravascular Coagulation ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Low Blood Pressure ◽  
Tunnel Syndrome ◽  
Nafamostat Mesylate

Nafamostat mesylate (NM) has been used to treat pancreatitis and disseminated intravascular coagulation during hemodialysis (HD). However, there have been some reports of adverse effects related to anaphylactic reactions. We present a case in which anaphylactic reactions caused by NM during preoperative HD caused repeated postponement of surgery for carpal tunnel syndrome. Symptoms including fever, shivering, chills, low blood pressure, tachycardia, nausea, and vomiting appeared during preoperative HD, and surgery was postponed thrice. Initially, the patient was misdiagnosed with sepsis because of elevated C-reactive protein and procalcitonin levels. However, since the symptoms appeared only when NM was administered and disappeared quickly after the administration of NM was terminated, the condition was diagnosed as anaphylactic reactions caused by NM. Therefore, it is essential to consider anaphylactic reactions caused by NM as differential diagnoses, when symptoms, such as fever, are observed during perioperative HD.

scholarly journals Adverse effects of percutaneous needle electrolysis in carpal tunnel syndrome

2019 ◽  
Vol 02 (02) ◽  
pp. 130-130
Author(s):  
Segura León JM ◽  
Medina i Mirapeix F. ◽  
Valera Garrido F.
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Adverse Effects ◽  
Carpal Tunnel ◽  
Medical Intervention ◽  
Nerve Lesion ◽  
Post Intervention ◽  
Nerve Entrapments ◽  
Tendon Lesion ◽  
Tunnel Syndrome

Abstract Background Percutaneous needle electrolysis is a physical therapy technique which has shown to be useful for the treatment of nerve entrapments. The aim of the present study was to analyze the possible adverse effects and the follow-up pattern after the application of percutaneous needle electrolysis in carpal tunnel syndrome. Material and Methods A descriptive observational study conducted at the Traumatology Service of the Ciudad Real Hospital, in patients with a medical diagnosis of carpal tunnel syndrome confirmed by electromyography (gold standard).Percutaneous needle electrolysis was applied under ultrasound guidance in the superficial and deep interphase of the median nerve in its passage through the carpal tunnel, applied with a frequency of once every seven days over four weeks.The week after each intervention, the follow-up pattern of the adverse effects variables was gathered, grouped in the following categories: type of adverse effect, moment of appearance, prevalence period, impact and causality.At 1.5 weeks and 6 weeks after the last intervention, the following variables were gathered: presence of painful or hypertrophic scar, stiffness at the level of the wrist, hand or fingers, infection of the wound, alteration of reflex sympathetic trophism, symptoms related with a nerve lesion, symptoms related with a tendon lesion, post intervention effusion. The McNemar test was used for comparative measures between the first, second, third and fourth intervention, without significant variations (p < 0.05). Results 30 cases participated in the study, of which one subject had to abandon the treatment after the first application because of apprehension in relation to following through with treatment.Of the 117 intervention applied, one vegetative reaction was recorded, which was transitory and without consequences. Pain appeared during the intervention in 96.5% of the interventions, after the intervention pain was present in 56%, whereas pain experienced days after the intervention occurred in 28.4%. No cases required further medical intervention, and there were no irreversible cases, independent of the cause. For the remaining variables, the records were negative in all interventions.No adverse effects were described for any cases at the follow up at 1.5 and 6 weeks post-intervention. Conclusions No adverse effects were described at the end of the intervention in the short to mid term. Regarding the follow-up pattern, the pain followed a highly homogeneous course, there were no irreversible adverse effects requiring intervention, and no relationship was found with any cause on behalf of the patient.

scholarly journals Etiopathogenic Value of the Associated Pathology in Carpal Tunnel Syndrome

2019 ◽  
Vol 25 (1) ◽  
pp. 36-39
Author(s):  
Pănculescu Florin Gabriel ◽  
Stefănescu Raluca ◽  
Bratu Iulian Cătălin ◽  
C. Podac ◽  
Bordeianu Ion
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Study Group ◽  
Exclusion Criteria ◽  
Men And Women ◽  
Obesity And Diabetes ◽  
Tunnel Syndrome ◽  
Bilateral Carpal Tunnel Syndrome

Abstract The present study focused on highlighting the pathology associated with carpal tunnel syndrome. Carpal tunnel syndrome is a susceptible neuropathy of the upper limb, its appearance being favored by the coexistence of other chronic pathologies. The study group consisted of 163 patients treated in the Plastic Surgery Clinic of the Emergency County Hospital in Constanţa, men and women of adulthood. The only exclusion criteria was non-compliant patients. The results were consistent with other studies published in the literature, with an over three times higher incidence of female sex. The decades of age most prone to the disease were the fourth, fifth, and sixth. Approximately one third of patients experienced bilateral carpal tunnel syndrome. A particularly important presence of the triad was found: hygh blood pressure, obesity and diabetes mellitus, at least one of which was present in over 70% of patients. The etiopathogenicity of the carpal tunnel syndrome is becoming clearer, the “Golden Trio” dominating the clinical picture in most patients.

scholarly journals A Review of Carpal Tunnel Syndrome and Its Association with Age, Body Mass Index, Cardiovascular Risk Factors, Hand Dominance, and Sex

2020 ◽  
Vol 10 (10) ◽  
pp. 3488 ◽  
Author(s):  
Melissa Airem Cazares-Manríquez ◽  
Claudia Camargo Wilson ◽  
Ricardo Vardasca ◽  
Jorge Luis García-Alcaraz ◽  
Jesús Everardo Olguín-Tiznado ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Body Mass Index ◽  
Carpal Tunnel Syndrome ◽  
Respiratory Rate ◽  
Carpal Tunnel ◽  
Abdominal Circumference ◽  
Cardiac Rate ◽  
Tunnel Syndrome ◽  
The Relationship

Carpal tunnel syndrome (CTS) is one of the most common compressive, canalicular neuropathies of the upper extremities, causing hand pain and impaired function. CTS results from compression or injury of the median nerve at the wrist within the confines of the carpal tunnel. Parameters such as age, sex, and body mass index (BMI) could be risk factors for CTS. This research work aimed to review the existing literature regarding the relationship between CTS and possible risk factors, such as age, sex, BMI, dominant hand, abdominal circumference, respiratory rate, blood pressure, and cardiac rate to determine which ones are the most influential, and therefore, take them into account in subsequent applied research in the manufacturing industry. We performed a literature search in the PubMed, EBSCO, and ScienceDirect databases using the following keywords: carpal tunnel syndrome AND (age OR sex OR BMI OR handedness OR abdominal circumference OR respiratory rate OR blood pressure OR cardiac rate). We chose 72 articles by analyzing the literature found based on selection criteria. We concluded that CTS is associated with age, female sex, and high BMI. Trends and future challenges have been proposed to delve into the relationship between risk factors and CTS, such as correlation studies on pain reduction, analysis of weight changes to predict the severity of this pathology, and its influence on clinical treatments.

Clinical Update: Assessing Maximum Medical Improvement in Carpal Tunnel Syndrome

2003 ◽  
Vol 8 (4) ◽  
pp. 4-5
Author(s):  
Christopher R. Brigham ◽  
James B. Talmage
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Proper Time ◽  
Carpal Tunnel Release ◽  
Hand Function ◽  
Factors Affecting ◽  
Early Results ◽  
Medical Evaluation ◽  
Nerve Recovery ◽  
Tunnel Syndrome

Abstract Permanent impairment cannot be assessed until the patient is at maximum medical improvement (MMI), but the proper time to test following carpal tunnel release often is not clear. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) states: “Factors affecting nerve recovery in compression lesions include nerve fiber pathology, level of injury, duration of injury, and status of end organs,” but age is not prognostic. The AMA Guides clarifies: “High axonotmesis lesions may take 1 to 2 years for maximum recovery, whereas even lesions at the wrist may take 6 to 9 months for maximal recovery of nerve function.” The authors review 3 studies that followed patients’ long-term recovery of hand function after open carpal tunnel release surgery and found that estimates of MMI ranged from 25 weeks to 24 months (for “significant improvement”) to 18 to 24 months. The authors suggest that if the early results of surgery suggest a patient's improvement in the activities of daily living (ADL) and an examination shows few or no symptoms, the result can be assessed early. If major symptoms and ADL problems persist, the examiner should wait at least 6 to 12 months, until symptoms appear to stop improving. A patient with carpal tunnel syndrome who declines a release can be rated for impairment, and, as appropriate, the physician may wish to make a written note of this in the medical evaluation report.

Clinical Update: Understanding Causation: An Example Using Carpal Tunnel Syndrome

2007 ◽  
Vol 12 (6) ◽  
pp. 5-8 ◽  
Author(s):  
J. Mark Melhorn
Keyword(s):  
Risk Factors ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Legal Responsibility ◽  
Medical Evidence ◽  
Anatomic Structure ◽  
Legal Professionals ◽  
Compensation Systems ◽  
Tunnel Syndrome ◽  
Four Levels

Abstract Medical evidence is drawn from observation, is multifactorial, and relies on the laws of probability rather than a single cause, but, in law, finding causation between a wrongful act and harm is essential to the attribution of legal responsibility. These different perspectives often result in dissatisfaction for litigants, uncertainty for judges, and friction between health care and legal professionals. Carpal tunnel syndrome (CTS) provides an example: Popular notions suggest that CTS results from occupational arm or hand use, but medical factors range from congenital or acquired anatomic structure, age, sex, and body mass index, and perhaps also involving hormonal disorders, diabetes, pregnancy, and others. The law separately considers two separate components of causation: cause in fact (a cause-and-effect relationship exists) and proximate or legal cause (two events are so closely related that liability can be attached to the first event). Workers’ compensation systems are a genuine, no-fault form of insurance, and evaluators should be aware of the relevant thresholds and legal definitions for the jurisdiction in which they provide an opinion. The AMA Guides to the Evaluation of Permanent Impairment contains a large number of specific references and outlines the methodology to evaluate CTS, including both occupational and nonoccupational risk factors and assigning one of four levels of evidence that supports the conclusion.

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