Dataset Information

Arterial abnormalities in the hands of workers with vibration white fingers - a magnetic resonance angiography case series.

ABSTRACT: Vibration white finger (VWF) is a complication from exposure to hand-arm vibrations. Poor knowledge of the pathophysiology of VWF means that making an accurate prognosis is difficult. Thus, a better understanding of VWF's pathophysiology is of importance.The purpose of this study was to investigate whether there were arterial abnormalities in the hands in patients with VWF and a positive Allen's test, using ultrasound and MRA imaging.This was a case series where arterial abnormalities in the hands were investigated in ten participants with VWF and using prolonged Allen's test (> 5 s). The participants had an average vibration exposure of 22 years and underwent Doppler ultrasound and Magnetic Resonance Angiography (MRA) to check for arterial abnormalities.The participants had VWF classified as 1-3 on the Stockholm workshop scale. Ultrasound and MRA identified vascular abnormalities in all participants, the predominant finding was missing or incomplete superficial arch. Also, stenosis was identified in four participants.This study reveals a high proportion of arterial stenosis and abnormalities in patients with VWF and a prolonged Allen's test.

SUBMITTER: Vihlborg P

PROVIDER: S-EPMC8320041 | biostudies-literature | 2021 Jul

REPOSITORIES: biostudies-literature

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Arterial abnormalities in the hands of workers with vibration white fingers - a magnetic resonance angiography case series.

Vihlborg Per P Makdoumi Karim K Gavlovská Hana H Wikström Sverre S Graff Pål P

Journal of occupational medicine and toxicology (London, England) 20210729 1

Vibration white finger (VWF) is a complication from exposure to hand-arm vibrations. Poor knowledge of the pathophysiology of VWF means that making an accurate prognosis is difficult. Thus, a better understanding of VWF's pathophysiology is of importance.The purpose of this study was to investigate whether there were arterial abnormalities in the hands in patients with VWF and a positive Allen's test, using ultrasound and MRA imaging.This was a case series where arterial abnormalities in the han ...[more]

PMID: 34325708

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Project description:PurposeThe purpose of this study was to evaluate circumstances surrounding power saw injuries. We hypothesized that power saw injuries are caused by either inexperienced or inappropriate usage of saws.MethodsA retrospective review of patients at our level 1 trauma center from January 2011 to April 2022 was conducted. Patients were screened using surgical billing records based on Current Procedural Terminology codes. Codes associated with revascularization; amputation of digits; and repair of tendon, nerve, and open metacarpal and phalanx fractures were queried. Patients who sustained power saw injuries were identified. They were then contacted by phone, and a standardized questionnaire was administered. Verbal consent was included in the standardized script, which was approved by the institutional review board.ResultsOne hundred eleven patients were identified who underwent surgical treatment for power saw injuries of the hands. Of them, we were able to contact 44 patients, who consented to and completed the questionnaire. Of all of the contacted patients, 40 (91%) were men, with an average age of 55 years (range, 27-80 years). No patients were intoxicated when the injury occurred. Thirty-two (73%) patients had used the same saw for more than 25 times. Sixteen (36%) patients had not received formal training regarding safe use of their saw, and 7 (16%) had removed a safety mechanism prior to the injury. Thirteen (30%) patients had used the saw on an unstable surface, and 17 (39%) reported not having changed the saw blade regularly.ConclusionsPower saw injuries occur for a multitude of reasons. Contrary to our hypothesis, more experience with the use of saws does not necessarily protect one from saw injuries. These findings highlight the need for formal training among new saw users and continuing education for the more experienced to help reduce the incidence of saw injuries that require surgical intervention.Type of study/level of evidencePrognostic IV.

Project description:ObjectivesTo determine the diagnostic accuracy of duplex ultrasonography, magnetic resonance angiography, and computed tomography angiography, alone or in combination, for the assessment of lower limb peripheral arterial disease; to evaluate the impact of these assessment methods on management of patients and outcomes; and to evaluate the evidence regarding attitudes of patients to these technologies and summarise available data on adverse events.DesignSystematic review.MethodsSearches of 11 electronic databases (to April 2005), six journals, and reference lists of included papers for relevant studies. Two reviewers independently selected studies, extracted data, and assessed quality. Diagnostic accuracy studies were assessed for quality with the QUADAS checklist.Results107 studies met the inclusion criteria; 58 studies provided data on diagnostic accuracy, one on outcomes in patients, four on attitudes of patients, and 44 on adverse events. Quality assessment highlighted limitations in the methods and quality of reporting. Most of the included studies reported results by arterial segment, rather than by limb or by patient, which does not account for the clustering of segments within patients, so specificities may be overstated. For the detection of stenosis of 50% or more in a lower limb vessel, contrast enhanced magnetic resonance angiography had the highest diagnostic accuracy with a median sensitivity of 95% (range 92-99.5%) and median specificity of 97% (64-99%). The results were 91% (89-99%) and 91% (83-97%) for computed tomography angiography and 88% (80-98%) and 96% (89-99%) for duplex ultrasonography. A controlled trial reported no significant differences in outcomes in patients after treatment plans based on duplex ultrasonography alone or conventional contrast angiography alone, though in 22% of patients supplementary contrast angiography was needed to form a treatment plan. The limited evidence available suggested that patients preferred magnetic resonance angiography (with or without contrast) to contrast angiography, with half expressing no preference between magnetic resonance angiography or duplex ultrasonography (among patients with no contraindications for magnetic resonance angiography, such as claustrophobia). Where data on adverse events were available, magnetic resonance angiography was associated with the highest proportion of adverse events, but these were mild. The most severe adverse events, although rare, were mainly associated with contrast angiography.ConclusionsContrast enhanced magnetic resonance angiography seems to be more specific than computed tomography angiography (that is, better at ruling out stenosis over 50%) and more sensitive than duplex ultrasonography (that is, better at ruling in stenosis over 50%) and was generally preferred by patients over contrast angiography. Computed tomography angiography was also preferred by patients over contrast angiography; no data on patients' preference between duplex ultrasonography and contrast angiography were available. Where available, contrast enhanced magnetic resonance angiography might be a viable alternative to contrast angiography.

Dataset Information

Arterial abnormalities in the hands of workers with vibration white fingers - a magnetic resonance angiography case series.

Publications

Arterial abnormalities in the hands of workers with vibration white fingers - a magnetic resonance angiography case series.

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