UlyssesJr Diva - Academia.edu (original) (raw)
Papers by UlyssesJr Diva
The eVect of diVerent warming methods on sensory nerve conduction velocity in shipyard workers occupationally exposed to hand-arm vibration
Int Arch Occup Envir Health, 2008
The Journal of the Acoustical Society of America, 2007
Two tools for assessing tactile sensory disturbances in the hands have been constructed from mech... more Two tools for assessing tactile sensory disturbances in the hands have been constructed from mechanoreceptor-specific vibrotactile threshold shifts, and thresholds changes with time, and employed in a prospective study of forest workers (N=18). Statistically significant positive threshold shifts (i.e., reductions in sensitivity compared to the hands of healthy persons) were found in five hands at study inception (13.9%), and 15 hands at follow-up (41.7%). Four patterns of threshold shift could be identified, involving selectively the median and/or ulnar nerve pathways and/or end organs. Statistically significant positive threshold changes (i.e., reductions in sensitivity with time) were recorded in 69.4% of the hands over a five-year period, even though a majority of the workers remained symptom free. If the thresholds recorded from subjects not working with power tools are used to control for aging, lifestyle, and environmental factors during the five year period, then 40% of the r...
The effect of different warming methods on sensory nerve conduction velocity in shipyard workers occupationally exposed to hand–arm vibration
International Archives of Occupational and Environmental Health, 2008
Segmental sensory nerve conduction velocity (SNCV) was measured from the wrists to the hands and ... more Segmental sensory nerve conduction velocity (SNCV) was measured from the wrists to the hands and digits in a population of 134 (126 men and 8 women) vibration-exposed shipyard workers following systemic warming using a bicycle ergometer. Results were compared to earlier nerve conduction tests, identical in execution, except that the warming process was segmental and cutaneous. The study was designed to investigate whether SNCVs, which were selectively slow in the fingers after segmental cutaneous (skin surface) warming, would be affected differently by systemic warming. Wrist-palm, palm-proximal digit, and digital sensory nerve segments were assessed antidromically by stimulating at the wrist with recording electrodes placed distally. The same subjects were cutaneously warmed in 2001 to >or=31 degrees C and were systemically warmed 28 months later in 2004 by ramped sustained exercise to 100 W for 12 min. Skin temperatures were measured by traditional thermistry and by infrared thermal images taken over the hand and wrist surfaces. When systemic warming was compared to segmental cutaneous warming, SNCVs were increased by 15.1% in the third digit and 20.4% in the fifth digit of the dominant hand. Respective increases in the non-dominant hand were 11.0% and 19.4%. A strong association between increased surface skin temperature and faster SNCV, which had been observed after segmental cutaneous warming, was largely eliminated for both digit and palmar anatomic segments after systemic warming. Significant differences in SNCV between vibration-exposed and non-exposed workers, which had been observed after segmental cutaneous warming, were eliminated after systemic warming. Systemic warming had only a small effect on the wrist-palm (transcarpal) segmental SNCVs. Reduced SNCV in the digits was observed in vibration-exposed and non-exposed workers. Substituting exercise-induced systemic warming for segmental cutaneous warming significantly increased SNCV in the digits and appeared to reduce differences in SNCV between vibration-exposed and non-exposed workers. These findings persisted despite a substantial time interval between tests, during which the subjects continued to work. There may be more general implications for diagnosing clinical conditions in industrial workers, such as the carpal tunnel syndrome and the hand-arm vibration syndrome.
Syndromes from segmental vibration and nerve entrapment: observations on case definitions for carpal tunnel syndrome
International Archives of Occupational and Environmental Health, 2007
The purpose of this paper is to assess the overlap and stability of two different case definition... more The purpose of this paper is to assess the overlap and stability of two different case definitions of carpal tunnel syndrome CTS. The analysis considers the association between different case definitions and objective tests (sensory nerve conduction velocities, SNCVs and vibrotactile perception thresholds, TTS), and the natural history of CTS, in the context of two vibration-exposed cohorts. Clinical CTS cases were defined in two ways: (1) by the study physician using fixed criteria, and; (2) by questionnaire and hand diagram. SNCV in median and ulnar nerves was measured for digital, transpalmar, and transcarpal segments, and conventionally as from wrist-digit. Skin temperature was assessed as a point measurement by thermistor and regionally by thermal imaging. VTTs were determined at the bilateral fingertips of the third and fifth digits using a tactometer meeting the requirements of ISO 13091-1 (ISO 2001). The subjects were cohorts of shipyard workers in 2001 and 2004, and dental hygienists in 2002 and 2004. Results are reported for 214 shipyard workers in 2001 and 135 in 2004, and for 94 dental hygienists in 2002 and 66 in 2004. In 2001, 50% of shipyard workers were diagnosed as CTS cases by at least one of the diagnostic schemes, but only 20% were positive by both criteria. Among study physician diagnosed cases, 64% were CTS negative in 2001, 76% were negative in 2004, 13% were positive in both years, 22% became negative after being positive, and 11% became positive after being negative. For only study physician diagnosed CTS did VTTs differ between cases differ and non-cases in digit 3; there was no such distinction in digit 5. The dental hygienists had little CTS. Clinical case definitions of CTS based on diagrams and self-assessment, and clinical evaluation have limited overlap. Combining clinical criteria to create a more narrow or specific case definition of CTS does not appear to predict SNCV. The natural history of CTS suggests a protean disorder with considerable flux in case status over time.
The eVect of diVerent warming methods on sensory nerve conduction velocity in shipyard workers occupationally exposed to hand-arm vibration
Int Arch Occup Envir Health, 2008
The Journal of the Acoustical Society of America, 2007
Two tools for assessing tactile sensory disturbances in the hands have been constructed from mech... more Two tools for assessing tactile sensory disturbances in the hands have been constructed from mechanoreceptor-specific vibrotactile threshold shifts, and thresholds changes with time, and employed in a prospective study of forest workers (N=18). Statistically significant positive threshold shifts (i.e., reductions in sensitivity compared to the hands of healthy persons) were found in five hands at study inception (13.9%), and 15 hands at follow-up (41.7%). Four patterns of threshold shift could be identified, involving selectively the median and/or ulnar nerve pathways and/or end organs. Statistically significant positive threshold changes (i.e., reductions in sensitivity with time) were recorded in 69.4% of the hands over a five-year period, even though a majority of the workers remained symptom free. If the thresholds recorded from subjects not working with power tools are used to control for aging, lifestyle, and environmental factors during the five year period, then 40% of the r...
The effect of different warming methods on sensory nerve conduction velocity in shipyard workers occupationally exposed to hand–arm vibration
International Archives of Occupational and Environmental Health, 2008
Segmental sensory nerve conduction velocity (SNCV) was measured from the wrists to the hands and ... more Segmental sensory nerve conduction velocity (SNCV) was measured from the wrists to the hands and digits in a population of 134 (126 men and 8 women) vibration-exposed shipyard workers following systemic warming using a bicycle ergometer. Results were compared to earlier nerve conduction tests, identical in execution, except that the warming process was segmental and cutaneous. The study was designed to investigate whether SNCVs, which were selectively slow in the fingers after segmental cutaneous (skin surface) warming, would be affected differently by systemic warming. Wrist-palm, palm-proximal digit, and digital sensory nerve segments were assessed antidromically by stimulating at the wrist with recording electrodes placed distally. The same subjects were cutaneously warmed in 2001 to >or=31 degrees C and were systemically warmed 28 months later in 2004 by ramped sustained exercise to 100 W for 12 min. Skin temperatures were measured by traditional thermistry and by infrared thermal images taken over the hand and wrist surfaces. When systemic warming was compared to segmental cutaneous warming, SNCVs were increased by 15.1% in the third digit and 20.4% in the fifth digit of the dominant hand. Respective increases in the non-dominant hand were 11.0% and 19.4%. A strong association between increased surface skin temperature and faster SNCV, which had been observed after segmental cutaneous warming, was largely eliminated for both digit and palmar anatomic segments after systemic warming. Significant differences in SNCV between vibration-exposed and non-exposed workers, which had been observed after segmental cutaneous warming, were eliminated after systemic warming. Systemic warming had only a small effect on the wrist-palm (transcarpal) segmental SNCVs. Reduced SNCV in the digits was observed in vibration-exposed and non-exposed workers. Substituting exercise-induced systemic warming for segmental cutaneous warming significantly increased SNCV in the digits and appeared to reduce differences in SNCV between vibration-exposed and non-exposed workers. These findings persisted despite a substantial time interval between tests, during which the subjects continued to work. There may be more general implications for diagnosing clinical conditions in industrial workers, such as the carpal tunnel syndrome and the hand-arm vibration syndrome.
Syndromes from segmental vibration and nerve entrapment: observations on case definitions for carpal tunnel syndrome
International Archives of Occupational and Environmental Health, 2007
The purpose of this paper is to assess the overlap and stability of two different case definition... more The purpose of this paper is to assess the overlap and stability of two different case definitions of carpal tunnel syndrome CTS. The analysis considers the association between different case definitions and objective tests (sensory nerve conduction velocities, SNCVs and vibrotactile perception thresholds, TTS), and the natural history of CTS, in the context of two vibration-exposed cohorts. Clinical CTS cases were defined in two ways: (1) by the study physician using fixed criteria, and; (2) by questionnaire and hand diagram. SNCV in median and ulnar nerves was measured for digital, transpalmar, and transcarpal segments, and conventionally as from wrist-digit. Skin temperature was assessed as a point measurement by thermistor and regionally by thermal imaging. VTTs were determined at the bilateral fingertips of the third and fifth digits using a tactometer meeting the requirements of ISO 13091-1 (ISO 2001). The subjects were cohorts of shipyard workers in 2001 and 2004, and dental hygienists in 2002 and 2004. Results are reported for 214 shipyard workers in 2001 and 135 in 2004, and for 94 dental hygienists in 2002 and 66 in 2004. In 2001, 50% of shipyard workers were diagnosed as CTS cases by at least one of the diagnostic schemes, but only 20% were positive by both criteria. Among study physician diagnosed cases, 64% were CTS negative in 2001, 76% were negative in 2004, 13% were positive in both years, 22% became negative after being positive, and 11% became positive after being negative. For only study physician diagnosed CTS did VTTs differ between cases differ and non-cases in digit 3; there was no such distinction in digit 5. The dental hygienists had little CTS. Clinical case definitions of CTS based on diagrams and self-assessment, and clinical evaluation have limited overlap. Combining clinical criteria to create a more narrow or specific case definition of CTS does not appear to predict SNCV. The natural history of CTS suggests a protean disorder with considerable flux in case status over time.