Characteristics Of Carpal Tunnel Syndrome Research Articles

Association between baseline characteristics of carpal tunnel syndrome and its relation to psychometric properties of the Boston carpal tunnel questionnaire

Objectives: Carpal tunnel syndrome (CTS) generally causes functional disabilities and consequently develops socioeconomic burdens for individuals and our community in the long run. The negative consequences are more recorded in developing nations. Therefore, early addressing the disorder is essential to eliminate the negative impacts on any health-care system. Methods: This descriptive cross-sectional study was conducted on patients with CTS attending the professorial surgical clinics at Teaching Hospital Jaffna. The demographic and clinical presentation while a self-reported Boston Carpal Tunnel Questionnaire (BCTQ) was used to assess the severity of symptoms and functional status of the wrist and hand. Results: This study involved 63 respondents whose mean age and body mass index were 55.4 ± 12.4 years and 25.6 ± 3.1, respectively. The larger proportion was female (74.6%) and the majority’s civil status was married (90.5%). Menial and skilled jobs were 46.6% and 31.7%, respectively, whereas the remaining were professionals. The right-hand dominance was 93.7%, although 57.1% had the right hand affected. There was a significant association (r = 0.739 and P = 0.0001) between the clinical tests and the severity of symptoms score. Conclusion: This study outcomes of CTSs severity and functional status with the BCTQ recommend that this tool and its scales indicate the association between CTSs baseline characteristics and impairments resulting from CTS in the clinical context.

Characteristics of carpal tunnel syndrome in patients with cervical radiculopathy: A cross-sectional study.

Cervical radiculopathy (CR) is a group of signs and symptoms caused by cervical root dysfunction. Patients with this condition may also have carpal tunnel syndrome (CTS), which is caused by compression of the median nerve in the carpal tunnel. This coexistent condition is referred to as double crush syndrome (DCS) which is explained by proximal disruption in axoplasmic flow that may result in nerve dysfunction. Yet, the accuracy of this hypothesis remains controversial. Patients with confirmed CR according to electromyography were included in this retrospective study. However, we omitted patients with overt diabetic neuropathy, prior spinal or hand surgery and/or fractures, and rheumatoid arthritis. Patients underwent electrodiagnostic studies, and the results were used to determine CTS severity. We used Pearson's χ 2 test to assess the correlation between the severity of CTS and CR. Descriptive analysis was used to report patient characteristics and the prevalence of CTS in CR patients. We included 291 participants, 59% of whom were women. Although insignificant, DCS was observed more in women (n = 110) compared to men (n = 71). However, we found that patients with DCS (54.81 ± 13.3) were older than non-DCS patients (43.71 ± 12.94) which was statistically significant (p < 0.05). There was statistically no correlation between the severity of CR and CTS, ipsilaterlly (p > 0.05). In total, CTS was observed in 62.2% (n = 181) patients. In summary, we found a relatively high prevalence of DCS in the present study. In patients with and without DCS, gender did not seem to play a role but the growing age seemed to contribute to DCS. The severity of CTS was not related to CR severity at any cervical level, which negates a causal relation between the pre-existing CR and newly diagnosed CTS.

Characteristics of Carpal Tunnel Syndrome in Wild-Type Transthyretin Amyloidosis.

Carpal tunnel syndrome (CTS) is one of the most common extra-cardiac manifestations of wild-type transthyretin amyloidosis (wtATTR); however, the characteristics of CTS in this population remain poorly understood. This retrospective cohort study reports findings from a single-centre experience of comprehensive neurological screening at the time of wtATTR diagnosis by nerve conduction studies (NCS) and neurologist assessment. Seventy-nine patients underwent neurological screening, 73 (92%) males, mean age 79.2 ± 7.5 years. Seventy-four (94%) had electrodiagnostic findings of median neuropathy at the wrist (MNW), 37 (50%) of which had a prior diagnosis of CTS and 37 (50%) had a new diagnosis of MNW. Over half of wtATTR patients (42, 53%) had bilateral MNW on screening. Most with pre-existing CTS had bilateral disease (28, 76%) and underwent bilateral carpal tunnel release (CTR) (23, 62%) prior to screening. Twenty-one (19%) wrists had mild MNW, 43 (38%) moderateand 49 (43%) severe. Twenty-one (28%) wtATTR patients with MNW were asymptomatic, 10 of which (48%) had moderate disease. Nineteen (36%) wtATTR patients with symptomatic MNW had recurrent disease despite previous CTR. As a result of screening, 36 (68%) patients with symptomatic MNW were referred for CTR. MNW is exceptionally common at the time of wtATTR diagnosis, affecting 94% of our patients. Most had severe, bilateral MNW on NCS. Some were asymptomatic, despite having moderate disease. The rate of recurrence following CTR was observed to be higher in wtATTR patients than the general population.

Body mass index and carpal tunnel syndrome: A case-control study.

To investigate the electrophysiological characteristics of carpal tunnel syndrome (CTS) and to evaluate the relationship between electrophysiological indexes and body mass index (BMI). In the analysis of 153 hospitalized patients with CTS, the median motor conduction velocity, motor conduction amplitude, motor conduction latency, sensor conduction velocity, sensor conduction amplitude and median sensory latency were analyzed. BMI was calculated. Total 171 healthy individuals were selected as control group. According to Guidelines for Prevention and Control of Overweight and Obesity in Chinese Adults, patients were divided into groups A, B and C. Patients with BMI (kg/m2) <24 were classified into group A; those with 24 ≤ BMI < 28 were regarded as overweight and classified into group B; and those with BMI ≥ 28 were regarded as obese and classified into group C. The BMI of CTS patients was significantly higher than that of healthy individuals (P < .05). For the sensory nerve, with the increase of BMI, the incubation period was gradually prolonged and the conduction velocity gradually decreases (P < .05). In terms of motor latency, with an increase in BMI, the latency showed a trend of first decreasing and then increasing, while the conduction velocity showed a trend of first increasing and then decreasing (P < .05). Electrophysiological examination plays an important supporting role in the diagnosis of CTS. BMI is positively correlated with the degree of CTS injury to a certain extent. Weight loss can effectively prevent the occurrence of CTS and slow the progression of nerve damage in CTS patients.

Characteristics of Carpal Tunnel Syndrome in Wild-Type Transthyretin Amyloidosis (P11-8.007)

<h3>Objective:</h3> The purpose of our study was to evaluate the prevalence, clinical features, severity, and disease course of carpal tunnel syndrome (CTS) in wild-type transthyretin amyloidosis (wtATTR) patients, as well as the risk of recurrence following carpal tunnel release (CTR). <h3>Background:</h3> Wild-type transthyretin amyloidosis is an important cause of infiltrative cardiomyopathy, particularly in older males. Carpal tunnel syndrome is one of the most common extra-cardiac manifestations of wtATTR and can predate cardiac symptoms by 5–10 years. The association between CTS and wtATTR has been described in several case series; however, the characteristics of CTS in this population remain poorly understood. <h3>Design/Methods:</h3> This retrospective cohort study reports findings from a single-center experience of routine neurological screening of newly diagnosed wtATTR patients including nerve conduction studies. Consecutive wtATTR patients between 2014 and 2021 were included. <h3>Results:</h3> Seventy-nine wtATTR patients were included; 73 (92%) males, mean age of 79 years. Seventy-one (90%) met electrodiagnostic criteria for median neuropathy at the wrist (MNW), 50% had a prior diagnosis and 50% were newly diagnosed at screening. The majority with MNW were symptomatic (53, 67%) with moderate or severe disease (66, 84%) bilaterally (42, 53%) on electrophysiologic testing. Fifty-six percent of our asymptomatic patients had moderate disease at the time of screening. Nineteen (24%) had recurrent CTS despite previous CTR. At the time of screening, 19 (24%) were prescribed wrist splinting and 36 (46%) were referred for CTR. <h3>Conclusions:</h3> Median neuropathy at the wrist affects the vast majority of wtATTR patients. CTS was confirmed in 67% of our patients, most had bilateral disease with moderate to severe MNW on electrophysiology at the time of wtATTR diagnosis. Recurrence after CTR was seen in 27% of our patients at the time of screening, which is higher than the rate of recurrence in the general population, estimated at 3–20%. <b>Disclosure:</b> Dr. Russell has nothing to disclose. Dr. Khayambashi has nothing to disclose. Nowell Fine has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of the American College of Cardiology: Case Reports. The institution of Nowell Fine has received research support from Pfizer, Akcea. The institution of Dr. Chhibber has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amylyx. Dr. Chhibber has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amylyx. Dr. Hahn has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Akcea. Dr. Hahn has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Anylim.

Deep CTS: a Deep Neural Network for Identification MRI of Carpal Tunnel Syndrome.

Carpal tunnel syndrome (CTS) is a common peripheral nerve disease in adults; it can cause pain, numbness, and even muscle atrophy and will adversely affect patients' daily life and work. There are no standard diagnostic criteria that go against the early diagnosis and treatment of patients. MRI as a novel imaging technique can show the patient's condition more objectively, and several characteristics of carpal tunnel syndrome have been found. However, various image sequences, heavy artifacts, small lesion characteristics, high volume of imagine reading, and high difficulty in MRI interpretation limit its application in clinical practice. With the development of automatic image segmentation technology, the algorithm has great potential in medical imaging. The challenge is that the segmentation target is too small, and there are two categories of images with the proximal border of the carpal tunnel as the boundary. To meet the challenge, we propose an end-to-end deep learning framework called Deep CTS to segment the carpal tunnel from the MR image. The Deep CTS consists of the shape classifier with a simple convolutional neural network and the carpal tunnel region segmentation with simplified U-Net. With the specialized structure for the carpal tunnel, Deep CTS can segment the carpal tunnel region efficiently and improve the intersection over union of results. The experimental results demonstrated that the performance of the proposed deep learning framework is better than other segmentation networks for small objects. We trained the model with 333 images, tested it with 82 images, and achieved 0.63 accuracy of intersection over union and 0.17s segmentation efficiency, which indicate great promise for the clinical application of this algorithm.

P.041 Characteristics of carpal tunnel syndrome in wild-type transthyretin amyloidosis

Background: Wild-type transthyretin amyloidosis (wtATTR) is an important cause of infiltrative cardiomyopathy in older adults. Carpal tunnel syndrome (CTS) is one of the most common extra-cardiac manifestations of wtATTR; however, the prevalence, severity, and risk of recurrence following carpal tunnel release (CTR) remain poorly understood. Methods: This retrospective cohort study reports findings from a single-centre experience of routine neurological screening of newly diagnosed wtATTR patients including nerve conduction studies. Consecutive wtATTR patients between 2014 and 2021 were included. Results: Seventy-nine wtATTR patients were included, 73 (92%) males, mean age of 79 years. Seventy-four (94%) had median neuropathy at the wrist (MNW), 50% having a prior diagnosis with the remaining 50% being diagnosed at screening. The majority with MNW were symptomatic (53, 67%) with moderate or severe disease (66, 84%) bilaterally (42, 53%) on electrophysiologic testing. Nineteen (24%) had recurrent CTS despite previous CTR. At the time of screening, 19 (24%) were prescribed wrist splinting and 36 (46%) were referred for CTR. Conclusions: Carpal tunnel syndrome is common in wtATTR. Most have bilateral disease with moderate to severe MNW at the time of wtATTR diagnosis. Recurrence of CTS after CTR is more common in wtATTR patients than in the general population.

Effects of Benign Joint Hypermobility Syndrome on the Clinical Characteristics of Carpal Tunnel Syndrome in Females.

Background and PurposeThe study aim was to determine the effects of benign joint hypermobility syndrome (BJHS) on symptom severity and functional capacity in females with carpal tunnel syndrome (CTS) based on the findings of physical examinations.MethodsOne hundred female patients diagnosed with bilateral CTS in electrophysiological testing were included in this study. The participants were evaluated for BJHS using the Brighton 1998 criteria, and divided into two groups: one consisting of 56 CTS patients with BJHS, and the other comprising 44 CTS patients without BJHS. Tinel’s, Phalen’s, and reverse Phalen’s tests were applied to all patients, and the severity and functional capacity of CTS were evaluated using the Boston Carpal Tunnel Syndrome Questionnaire.ResultsSymptom severity and functional capacity varied significantly between the two groups in the right hand (p=0.037 and p=0.039, respectively) and in the left hand (p=0.016 and p=0.029). The hypermobile group yielded more positive results on the right side during Tinel’s, Phalen’s, and reverse Phalen’s tests (p=0.032, p=0.032, and p=0.018, respectively).ConclusionsHypermobility in females exacerbated the symptoms of CTS and led to a further reduction of functional capacity. Therefore, hypermobility should be tested and an intense exercise program should be implemented in BJHS patients, especially in females with CTS.

Differences in characteristics of carpal tunnel syndrome between male and female patients

BackgroundSex difference is known to be a risk factor of carpal tunnel syndrome. However, sex differences with regard to the clinical presentation of carpal tunnel syndrome have not received much attention. Thus, this study aimed to detect any difference in the characteristics of carpal tunnel syndrome between male and female and thereby add new insights into disease prevention. MethodsA total of 647 patients (male 193 hands and female 454 hands) with carpal tunnel syndrome who underwent endoscopic or open carpal tunnel release were retrospectively reviewed. The average age at time of surgery was 66 years. Clinical and electrophysiological data of all patients were collected. Six medical conditions, including trigger finger, diabetes mellitus, hemodialysis, hyperlipidemia, hypertension, and obesity were also investigated. ResultsA significant difference was found in the distribution of comorbidities between the male and female groups. Particularly, the prevalence of diabetes mellitus, hemodialysis, and hypertension were significantly higher in the male group than in the female group. Meanwhile, the presence of thenar muscle atrophy was significantly higher in the female group than in the male group. ConclusionsWomen are more likely to experience carpal tunnel syndrome even though they have no comorbidities. We suggest that carpal tunnel syndrome especially in male patients may be reduced by early intervention for diabetes mellitus. Prospective studies are needed to validate the causal relationship between diabetes mellitus and carpal tunnel syndrome.

DYNAMICS OF CLINICAL AND ELECTROPHYSIOLOGICAL CHARACTERISTICS OF CARPAL TUNNEL SYNDROME IN CHILDREN WITH MUCOPOLYSACCHARIDOSES AGAINST THE BACKGROUND OF ENZYME-REPLACEMENT THERAPY

Introduction. Mucopolysaccharidoses are the most common cause of the carpal tunnel syndrome in children. Enzyme-replacement therapy, which is available in clinical practice within last 10-15 years for mucopolysaccharidoses I, II and VI demonstrated the efficacy regarding somatic symptoms of the diseases, however, the impact of this new pathogenetic treatment on neuropathy of median nerve, arising from compression in the carpal tunnel, is poorly described. Objective. To study the dynamics of clinical and electrophysiological characteristics of carpal tunnel syndrome in children with mucopolysaccharidoses during enzyme-replacement therapy. Materials and methods. 18 children with mucopolysaccharidoses I, II and VI, received enzyme-replacement therapy, are included in the study. Dynamics of clinical symptoms of the carpal tunnel syndrome and EMG indices of median nerve testing are described against the background of enzyme-replacement therapy. Results. Objective and subjective clinical manifestations of the carpal tunnel syndrome persisted or appeared in children, receiving enzyme-replacement therapy for 21±12 months. However, there were no statistically significant changes in EMG-characteristics of median nerves testing during enzyme-replacement therapy in children with mucopolysaccharidoses Conclusion. Enzyme-replacement therapy in children with mucopolysaccharidoses I, II and VI may suspend and/or delay progressive damage of median nerves in the carpal canal, thus indicating prevention and slowing down in glycosaminoglycans storage in the carpal tunnel.

Distribution of age, gender, and occupation among individuals with carpal tunnel syndrome based on the National Health Insurance data and National Employment Insurance data

BackgroundThe present study aimed to investigate the basic characteristics of carpal tunnel syndrome (CTS) and its differences between occupations using Korea's National Health Insurance (NHI) and National Employment Insurance (NEI).MethodsThe study participants were obtained from the NEI and NHI data from 2008 to 2015, with a diagnosis code of G560 (CTS) as the main or sub-diagnosis. Data about gender, age, diabetes mellitus, smoking, drinking, and length of employment, information about type of occupation, and number of employees according to age and occupation were obtained from NHI and NEI data. In total, 240 occupations were classified into blue-collar (BC) and white-collar (WC) work. In addition, each occupation was classified as high-risk and low-risk groups depending on the degree of wrist usage.ResultsThe number of patients with CTS per 100,000 individuals increased with advancing age, and it was higher in women (4,572.2) than in men (1,798.5). Furthermore, the number was higher in BC workers (3,247.5) than in WC workers (1,824.1) as well as in the high-risk group than in the low-risk group in both BC workers (3,527.8 vs. 1,908.2) and WC workers (1,829.9 vs. 1,754.4). The number of patients with CTS was higher in the high-risk group than in the low-risk group among male and female BC workers and female WC workers. However, the number was higher in the low-risk group among male WC workers. In the BC category, the number of patients with CTS was highest among food processing-related workers (19,984.5). In the WC category, the number of patients with CTS was highest among social workers and counselors (7,444.1).ConclusionsThe results of this study are expected to help identify occupational differences in patterns of CTS. High number of patients with CTS was seen in new jobs, as well as in previous studies.

A study of patient characteristics of carpal tunnel syndrome and its correlation with electro-diagnostic findings

A study of patient characteristics of carpal tunnel syndrome and its correlation with electro-diagnostic findings

Carpal Tunnel Syndrome Prevalence and Characteristics among Administrative Staff at Dr.Hasan Sadikin General Hospital Bandung

Background: Carpal tunnel syndrome (CTS) is a neurologic disease affecting hands, which is closely related to work, and is the most prevalent nerve compression disease. The incidence of CTS quite often occur in people working with their hands, for instance the administrative staff, especially in a busy workplace such as Dr.Hasan Sadikin General Hospital Bandung. CTS causes reduction in work productivity, and consequently degrading family welfare and the quality of public service. For that very reason, the prevalence and characteristics of CTS among administrative staff at Dr.HasanSadikin General Hospital Bandung needed to be revealed. Methods: This quantitative descriptive study involved 94 administrative staff in the Medical record department of Dr. Hasan Sadikin General Hospital using the Carpal-tunnel.net questionnaire and further examinations by neurologists. Variables involved in this study were the subject characteristics. Results: Out of the 90 subjects, 22 stated having symptoms related to CTS (prevalence, 24.4%). On further clinical examination, 3 were diagnosed of suffering from CTS (prevalence, 3.3%). Conclusions: Carpal tunnel syndrome is found among the administrative staff at Dr. Hasan Sadikin General Hospital Bandung and the prevalence is lower than in the general population. A further study is required to reveal ther specific division in the hospital with the most prevalent CTS case. DOI: 10.15850/amj.v4n2.1077

Prevalence and Related Characteristics of Carpal Tunnel Syndrome Among Orchardists in the Gyeongsangnam-do Region.

ObjectiveTo determine the prevalence and related characteristics of carpal tunnel syndrome (CTS) in orchardists and to investigate the association between electrodiagnostic severity and physical examinations.MethodsBetween July 2013 and September 2014, 377 subjects (174 men and 203 women) visited the Gyeongsang National University Hospital's Center for Farmer's Safety and Health. All the subjects underwent electrodiagnostic tests and physical examination, including Phalen's test, Tinel's sign, and Durkan's carpal compression test (CCT). The subjects were classified into 2 groups, the normal group and the CTS group, according to electrodiagnostic test results. To determine the related characteristics of CTS, potential variables, including age, sex, drinking, smoking, body mass index, waist circumference, and total work time, were compared between the 2 groups. The association between electrodiagnostic severity and physical examinations was analyzed.ResultsCTS was diagnosed in 194 subjects based only on electrodiagnostic test results, corresponding to a prevalence of 51.5%. Among the variables, mean age (p=0.001) and total work time (p=0.007) were significantly correlated with CTS. With respect to the physical examinations, low specificities were observed for Tinel's sign, Phalen's test, and Durkan's CCT (38.4%, 36.1%, and 40.9%, respectively) in the subjects aged ≥65 years. In addition, Phalen's test (p=0.003) and Tinel's sign (p=0.032) in men and Durkan's CCT (p=0.047) in women showed statistically significant differences with increasing CTS severity. The odds ratio was 2.066 for Durkan's CCT in women according to the multivariate logistic regression analysis.ConclusionCTS prevalence among orchardists was high, and Durkan's CCT result was significantly quantitatively correlated with the electrodiagnostic test results. Therefore, Durkan's CCT is another reliable examination method for CTS.

Seasonal variation and demographical characteristics of carpal tunnel syndrome in a Pakistani population.

To determine the demographic characteristics of gender, age, involvement of hand/hands and seasonal distribution in patients with a neurophysiological diagnosis of carpal tunnel syndrome (CTS). An observational study. Department of Neurology, Fauji Foundation Hospital, Rawalpindi and PIMS, Islamabad, during December 2006 to July 2009. Cases reported in the months of December and January (winter group) and those reported in the months of June and July (summer group), of any age and gender with electrophysiological confirmation of CTS were included. Those having median neuropathy in the region of elbow, brachial plexopathy and cervical radiculopathy (C6-7) or polyneuropathy were excluded. Nerve conduction study was done in Median nerve. Statistical significance between the two groups (summer and winter) was calculated. Among the 213 patients (320 hands) of CTS, 70 (105 hands) were in summer group and 143 (215 hands) were in winter group. There were 15 (21.43%) males and 55 (78.57%) females in summer group and 22 (15.38%) males and 121 (84.62%) females in winter group. The female hands were 83 (79.05%) and 182 (84.65%) and male hands were 22 (20.95%) and 33 (15.35%), respectively in summer and winter group. Mean age was 44.38 years and 45.16 years. The right hand was affected in 64 (60.95%) and 121 (56.28%); and the left hand was affected in 41 (39.05%) and 94 (43.72%) in summer and winter groups respectively. Half of the patients had bilateral involvement. The p-values for the NCS variables were not statistically significant. Presentation with CTS was more common in winter at the study centre. Female gender and dominant hand was affected more frequently. There were no significant changes in NCS parameters among the two groups.

P30-20 Clinical characteristics of carpal tunnel syndrome in diabetic patients

P30-20 Clinical characteristics of carpal tunnel syndrome in diabetic patients

Characteristics of carpal-tunnel syndrome in the ATAC trial.

Abstract Abstract #5085 Introduction: Carpal-tunnel syndrome (CTS) is a condition in which the median nerve is compressed leading to pain and muscle weakness in fingers and the hand. Oestrogen depletion has been shown to induce CTS, whereas the use of hormone replacement therapy is associated with a resolution of the symptom. Aromatase inhibitors lead to profound oestrogen suppression and therefore might induce CTS in postmenopausal women.&amp;#x2028; Methods: The Arimidex Tamoxifen Alone or in Combination (ATAC) trial randomised 9,366 postmenopausal women to anastrozole (1mg/day), tamoxifen (20mg/day) or the combination. Analyses were based on the 100 month median follow-up data in women in the two monotherapy arms who started their allocated treatment (anastrozole=3,092; tamoxifen=3,094). Here, we retrospectively investigate the influence of anastrozole on CTS, clinical outcomes, the relative importance of a range of risk factors for CTS, and examine whether they act differently in the presence of anastrozole treatment.&amp;#x2028; Results: During the entire active treatment period, 80 (2.6%) cases of CTS were reported in the anastrozole arm compared with 23 (0.7%) in the tamoxifen arm (OR=3.55 (2.22-5.65), P&amp;lt;0.001). In both treatment arms, the majority of CTS were reported as of mild or moderate severity. Most reports of CTS in the anastrozole arm occurred within 18 months of treatment initiation, but incidence remained elevated compared to the tamoxifen arm for the entire treatment period. Median time to resolution of CTS was 8.4 months and none of the women stopped treatment medication due to this adverse event. 13 women underwent carpal-tunnel release surgery (11 anastrozole (1 in 300) vs. 2 tamoxifen (1 in 1500)). Reports of CTS were significantly increased for women who used prior hormone replacement therapy (HRT) (2.3% vs. 1.3%, OR=1.72 (1.16-2.54), P=0.007) or prior chemotherapy (2.5% vs. 1.4%, OR=1.73 (1.14-2.62)). Furthermore, women who were aged 60 years or younger at entry were at greater risk of CTS compared with those aged 61 years or older (2.5% vs. 1.2%, OR=0.48 (0.30-0.76), P=0.002). Body mass index (BMI), hormone receptor status, smoking status, and prior radiotherapy were not found to be risk factors for the development of CTS. When analyses were restricted to only women receiving anastrozole, the same risk factors were identified.&amp;#x2028; Conclusions: Although the use of anastrozole is clearly associated with a greater incidence of CTS, it is rare and most cases were of mild severity and short duration and did not lead to treatment discontinuation or surgical intervention. Thus, while CTS can be quite debilitating for the few patients who have severe symptoms, this side effect has minimal impact on the overall risk-benefit ratio for the use of anastrozole in postmenopausal women. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5085.

Carpal tunnel syndrome in older adults

The clinical and electrophysiologic characteristics of carpal tunnel syndrome (CTS) in elderly adults are not well established. We examined age differences in clinical, functional, and electrophysiologic features in elderly adults referred to a neuromuscular service for evaluation of symptoms suggestive of CTS. Of 415 consecutive subjects referred over an 18-month period, 343 met clinical criteria for CTS. There were 158 young (<or=50 years), 115 middle-aged (51-64 years), and 70 elderly adults (>or=65 years). There were no age differences in the duration of CTS symptoms, hand function, or presence of autonomic symptoms. The elderly adults had a higher prevalence of thenar weakness and thenar atrophy than younger subjects. Electrophysiologic abnormalities were more common and more severe in the older subjects. Our study shows that although there are no age differences in subjective complaints of CTS, older adults had objective clinical and electrophysiologic evidence of a more severe median nerve entrapment. The findings suggest that greater attention needs to be paid to objective evidence of CTS severity rather than subjective complaints when evaluating elderly adults presenting for clinical evaluation of CTS.

Seasonal distribution and demographical characteristics of carpal tunnel syndrome in 1039 patients.

To describe the demographic characteristics of gender, age, and presence of repetitive movements, intake of alcohol and non-steroid anti-inflammatories (NSAI), medical specialties that referred patients to nerve conduction studies and electromyography (NCS-EMG), school attainment, and seasonal distribution in patients with a neurophysiological diagnosis of carpal tunnel syndrome (CTS) in the State of Rio Grande do Sul, Brazil. A series of 1039 patients (1549 hands) with neurophysiologically defined CTS was studied. Patients were referred for NCS-EMG in 3 universities and 2 private services, from August 2001 to January 2003. All patients completed a questionnaire containing demographic information. The diagnosis of CTS was established following a pre-established protocol, with defined diagnostic criteria. Around one fourth of patients had already performed NCS-EMG; the greatest frequency of CTS was observed in women (5.6:1) and in patients above the age of 40. Most patients reported performing repetitive movements in their daily routine (69.7%); 12.9% reported use of NSAI and 14.9% regular intake of alcoholic beverages. A greater frequency of CTS was observed in the months of July and August, when compared to the other months of the year. Around 2/3 of the study population had completed at least secondary school. Most requests of nerve conduction studies did not provide a diagnostic hypothesis (59.9%) and neurophysiologic studies were requested mostly by traumatology/orthopedics (71.1%). We have concluded that, in our environment, CTS shows some demographical characteristics that are similar to what the literature describes. Also, we have found that most of our sample concluded at least secondary school, and was referred to neurophysiologic studies by orthopedists. To be pointed out is the seasonal distribution of CTS, which demonstrates a significant association with winter months.

El síndrome del túnel del carpo en el síndrome del aceite tóxico

The toxic oil syndrome (TOS) is an autoimmune disease caused by the ingestion of aniline-denatured rapeseed oil. The carpal tunnel syndrome (CTS) is an entrapment neuropathy due to the median nerve entrapment, which is associated with both occupational activities and autoimmune diseases. The objective of this work was to know the frequency and characteristics of CTS in TOS patients. Between December 1977 and July 2000, 744 TOS patients were evaluated. The inclusion criteria were: the clinical records for patients diagnosed between May 1981 and November 1997; and for patients diagnosed between December 1997 and July 2000, symptoms with the classical or likely pattern according to the Katz's hand diagram and one of the following findings: a) abnormal electromyogram, and b) hypalgesia in the median nerve territory and positive Tinel and/or Phalen signs. A total of 70 patients (63 women, 90%) were diagnosed; 48 of them had been diagnosed before 1997 and 22 subsequently. The mean age of patients was 47.6 (20-78) years. In 36 patients (51.4%), a bilateral CTS was present. Fifty-six patients (81.4%) had a diagnostic EMG, and 31 (44.2%) were obese, 13 (18.6%) diabetic, and 4 (6%) had hypothyroidism. Most of these cases (48; 68.6%) were housewives. TOS patients have a high frequency of CTS; therefore, this condition must be suspected in patients with associated obesity and diabetes mellitus.