Symptoms of musculoskeletal disorders in stage rally drivers and co-drivers.
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BACKGROUND: During stage rallying, musculoskeletal injuries may be provoked by the high magnitude of vibration and shock to which the driver and co-driver are exposed. Drivers and co-drivers experience similar exposure to whole body mechanical shocks and vibration but different exposure to hand/wrist stressors. OBJECTIVES: To investigate by a questionnaire study the prevalence of symptoms of musculoskeletal injuries after rallying in 13 professional and 105 amateur stage rally competitors. METHODS: The self administered questionnaire investigated whole body and hand/wrist symptoms of musculoskeletal injury. It was loosely based on the Nordic design. RESULTS: 91% of participants who competed or tested for more than 10 days a year (n=90) reported discomfort in at least one body area after rallying. Problems in the lumbar spine (70%), cervical spine (54%), shoulders (47%), and thoracic spine (36%) were the most common. There was a higher prevalence of cervical spine discomfort for co-drivers (62%) than for drivers (46%). Conversely, there was higher prevalence of discomfort in the hands and wrists for drivers (32%) than co-drivers (9%). The prevalence of low back pain in rally participants is higher than that generally reported for workers exposed to whole body vibration. The prevalence of discomfort in the hand and wrist for rally drivers is similar to that previously reported for Formula 1 drivers. CONCLUSIONS: Most stage rally drivers and co-drivers report symptoms of musculoskeletal injury. It is logical to relate the high prevalence of symptoms of injury to the extreme environment of the rally car. (+info)
Sensory determinants of thermal pain.
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It is still unclear whether the quality of painful thermal sensation is determined only by conduction in specific, dedicated nociceptive channels (i.e. C or Adelta nociceptors) or whether it is a result of integrated activity in both nociceptive and non-nociceptive systems. To evaluate this question, we conducted quantitative and qualitative somatosensory testing in spinal cord injury subjects who suffered from partial or complete loss of thermal sensibility. Testing was performed in skin areas, below the level of the lesion, which were either lacking any thermal sensibility, lacking only one thermal sensation (either heat or cold) or having normal thermal sensations. We found that, in areas lacking any thermal sensibility, warm and cold stimuli produced a sensation of pricking pain, which had no thermal quality and was detected at significantly higher thresholds than in normal controls (48.5 +/- 1.8 and 9.7 +/- 5.1 degrees C for noxious heat- and noxious cold-induced pricking pain, respectively). Normal thermal pain sensations, consisting of normal perception of thermal quality and normal mean pain thresholds, were present both in normal skin areas (42.1 +/- 1.9 and 27.6 +/- 2.25 degrees C for heat and cold pain, respectively) and in areas in which only one thermal modality remained intact, when tested for that modality. Thus, testing for heat pain in areas in which only warm sensation was intact, or cold pain when only cold was intact produced normal qualities and thresholds of pain (42.8 +/- 3.4 and 24.4 +/- 6.2 degrees C for heat and cold pain, respectively). No spatial summation of pricking pain was observed, in contrast to the marked summation of heat pain in normal areas. In areas with only a single intact thermal modality, the quality of the perceived non-painful sensation was not determined by the thermal stimulus but by the intact modality (paradoxical sensation). Cold stimuli were perceived as warm in areas in which only warm sensation was preserved, and vice versa. A similar pattern was also seen for pain perception in areas with intact warm sensation. In these areas, both noxious heat and cold elicited a sensation of heat pain. No consistent pattern of heat-elicited pain was observed in areas in which only cold sensation was intact. These data suggest that the integrity of non-noxious thermal systems is essential for the normal perception of thermal pain, and that the subjective sensation of pain depends on the integration of information from nociceptive and non-nociceptive channels. (+info)
Recurrent neurological symptoms in a patient following repeat combined spinal and epidural anaesthesia.
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A healthy woman developed neurological symptoms after two consecutive Caesarean sections under combined spinal and epidural anaesthesia. Amethocaine was used for spinal anaesthesia and mepivacaine for epidural anaesthesia on both occasions, and a combination of fentanyl and bupivacaine was continuously infused for pain relief after the second. Her symptoms on both occasions were similar, including pain in the buttocks of 7-11 days duration and numbness in the sacral area of 5-6 months. (+info)
Presigmoid transpetrosal approach for the treatment of a large trochlear nerve schwannoma--case report.
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A 61-year-old man presented with a rare, large trochlear nerve schwannoma manifesting as left-sided weakness and hypesthesia, bilateral bulbar pareses, and trochlear nerve paresis persisting for 3 months. T1-weighted magnetic resonance imaging with gadolinium revealed an intensely enhanced, well-circumscribed lesion with multicystic formation occupying the prepontine and interpeduncular cisterns and compressing the pons and midbrain with greater extension to the right. The mass was completely removed through the presigmoid transpetrosal approach with preservation of the posterior cerebral, superior cerebellar, and basilar arteries and their branches. Neuroradiological examination after 3 years demonstrated no recurrence. Enlargement of a tumor in the cisternal portion is inclined to involve and/or encase the adjacent major arteries and their branches. The presigmoid transpetrosal approach is one of the best surgical routes to remove a large trochlear nerve schwannoma safely and completely. (+info)
Neurologic illness associated with eating Florida pufferfish, 2002.
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Since January 1, 2002, human illness after eating pufferfish caught in waters near Titusville, Florida, has been reported (Figure 1). The illnesses were manifested by neurologic symptoms consistent with exposure to paralytic shellfish toxins. Laboratory analysis in early April confirmed the presence of saxitoxin in uneaten pufferfish. This report presents selected case examples and summarizes all cases reported to the Toxic Exposure Surveillance System of the American Association of Poison Control Centers (TESS). (+info)
Update: Neurologic illness associated with eating Florida pufferfish, 2002.
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As of May 15, 2002, a total of 13 presumptive cases of saxitoxin poisoning were reported in Florida residents who ate pufferfish caught in waters near Titusville, Florida. Five cases were reported in April, and eight cases were identified through increased surveillance by Florida poison control centers, hospital emergency departments (EDs), and county health departments. This report updates the investigation of these cases. (+info)
Scapuloperoneal atrophy with sensory involvement: Davidenkow's syndrome.
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A patient with scapuloperoneal atrophy of neurogenic type, in whome there was also distal sensory impairment, has been studied with conventional EMG, single fibre EMG, and muscle biopsy. This disorder, described by Davidenkow, may be a distinct entity. (+info)
Anatomic distribution of sensory symptoms in the hand and their relation to neck pain, psychosocial variables, and occupational activities.
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To explore whether different distributions of numbness and tingling in the hand can be usefully distinguished in epidemiologic studies of disorders such as carpal tunnel syndrome, the authors used a postal questionnaire, an interview, and a physical examination to collect information about risk factors, symptoms, and signs from a general population sample of 2,142 adults in Southampton, England, during 1998-2000. The authors distinguished six distributions of numbness and tingling and compared their associations with other clinical findings and with known risk factors for upper limb disorders. Distinctive relations were found for symptoms that involved most of the palmar surface of the first three digits but not the dorsum of the hand or the little finger. Such symptoms were more often associated with positive Phalen's and Tinel's tests and, unlike other categories of sensory disturbance, were not related to neck pain or restriction of neck movement. They also differed in showing no association with lower vitality or poorer mental health but an association with repeated wrist and finger movements at work. These findings suggest that, in the classification of numbness and tingling of the hand, it may be useful to distinguish symptoms that involve most of the sensory distribution of the median nerve but not other parts of the hand. (+info)