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1.
Vascular anomalies of the upper limb.
Mende, K, Vargesson, N, Sivakumar, B
The Journal of hand surgery, European volume. 2019;(3):233-241
Abstract
Vascular anomalies are common in the upper extremities, but there continues to be a relative paucity of information about them in publications dealing with surgery in the hands and upper limbs. The wide spectrum of pathology and an inconsistent use of terminology make vascular anomalies susceptible to incorrect diagnosis and as a result, to misdirected management. This article aims to provide an update on vascular anomalies relevant to the upper limbs, focusing on significant advances in pathogenesis and genetics, classification systems, diagnosis and treatment.
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2.
Exercise therapy and work-related musculoskeletal disorders in sedentary workers.
Kelly, D, Shorthouse, F, Roffi, V, Tack, C
Occupational medicine (Oxford, England). 2018;(4):262-272
Abstract
BACKGROUND Work-related upper limb disorders (WRULDs) are a syndrome of symptoms affecting the upper quadrant of the body and are a significant cause of pain, disability and sickness absence among workers. Exercise therapy is considered to be a clinical and cost-effective strategy in WRULD management. AIMS To evaluate the effectiveness of exercise therapy for WRULDs in sedentary workers. METHODS This review follows an a priori protocol to maintain internal validity describing essential procedures to be followed (e.g. a comprehensive search strategy, duel extraction and critical appraisal). The methodological quality of the studies were assessed using Cochrane Risk of Bias Tool for all randomized controlled trials and the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool for systematic reviews. RESULTS A total of 11 articles were selected for inclusion. There was moderate evidence to suggest exercise is effective in reducing the symptoms of pain and improved function in WRULDs in sedentary workers when compared to a control group. CONCLUSIONS The results were comparable to recent systematic reviews, which have found evidence to support the use of exercise therapy, in mixed populations of workers. There is a need for further research to highlight the most effective form of exercise, optimal dosage and delivery method.
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3.
Creatine Supplementation and Upper Limb Strength Performance: A Systematic Review and Meta-Analysis.
Lanhers, C, Pereira, B, Naughton, G, Trousselard, M, Lesage, FX, Dutheil, F
Sports medicine (Auckland, N.Z.). 2017;(1):163-173
Abstract
BACKGROUND Creatine is the most widely used supplementation to increase performance in strength; however, the most recent meta-analysis focused specifically on supplementation responses in muscles of the lower limbs without regard to upper limbs. OBJECTIVE We aimed to systematically review the effect of creatine supplementation on upper limb strength performance. METHODS We conducted a systematic review and meta-analyses of all randomized controlled trials comparing creatine supplementation with a placebo, with strength performance measured in exercises shorter than 3 min in duration. The search strategy used the keywords 'creatine', 'supplementation', and 'performance'. Independent variables were age, sex and level of physical activity at baseline, while dependent variables were creatine loading, total dose, duration, time interval between baseline (T0) and the end of the supplementation (T1), and any training during supplementation. We conducted three meta-analyses: at T0 and T1, and on changes between T0 and T1. Each meta-analysis was stratified within upper limb muscle groups. RESULTS We included 53 studies (563 individuals in the creatine supplementation group and 575 controls). Results did not differ at T0, while, at T1, the effect size (ES) for bench press and chest press were 0.265 (95 % CI 0.132-0.398; p < 0.001) and 0.677 (95 % CI 0.149-1.206; p = 0.012), respectively. Overall, pectoral ES was 0.289 (95 % CI 0.160-0.419; p = 0.000), and global upper limb ES was 0.317 (95 % CI 0.185-0.449; p < 0.001). Meta-analysis of changes between T0 and T1 gave similar results. The meta-regression showed no link with characteristics of population or supplementation, demonstrating the efficacy of creatine independently of all listed conditions. CONCLUSION Creatine supplementation is effective in upper limb strength performance for exercise with a duration of less than 3 min, independent of population characteristics, training protocols, and supplementary doses or duration.
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4.
Effectiveness of Acupuncture Therapies to Manage Musculoskeletal Disorders of the Extremities: A Systematic Review.
Cox, J, Varatharajan, S, Côté, P, Optima Collaboration,
The Journal of orthopaedic and sports physical therapy. 2016;(6):409-29
Abstract
Study Design Systematic review. Background Little is known about the effectiveness of acupuncture therapies for musculoskeletal disorders. Objective To assess the effectiveness and safety of acupuncture therapies for musculoskeletal disorders of the extremities. Methods We searched MEDLINE, Embase, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trials from 1990 to 2015 for randomized controlled trials, cohort studies, and case-control studies. Eligible studies were appraised with Scottish Intercollegiate Guidelines Network criteria. A best-evidence synthesis was performed to synthesize results from included studies with a low risk of bias. A sensitivity analysis was conducted to determine the impact of excluding studies with a high risk of bias. Results The search revealed 5180 articles; 15 were included (10 with a low risk of bias, 5 with a high risk of bias). The studies with a low risk of bias suggested that (1) traditional needle acupuncture was superior to oral steroids (1 RCT, n = 77) and may be superior to vitamin B1/B6 supplements (1 RCT, n = 64) for carpal tunnel syndrome (CTS), and was superior to exercise for Achilles tendinopathy (1 RCT, n = 64). Traditional needle acupuncture did not provide important benefit over placebo for upper extremity pain (1 RCT, n = 128), or no intervention for patellofemoral pain (1 RCT, n = 75), and was inconclusive for shoulder pain (2 RCTs, n = 849), suggesting no important benefit; (2) electroacupuncture may be superior to placebo for shoulder injuries (1 RCT, n = 130) and may not be superior to night splinting for persistent CTS (1 RCT, n = 78); and (3) dry needling may be superior to placebo for plantar fasciitis (1 RCT, n = 84). Sensitivity analysis suggests that including studies with a high risk of bias might have impacted the evidence synthesis in support of managing shoulder pain with traditional needle acupuncture, and that would suggest traditional needle acupuncture may be effective for lateral epicondylitis and piriformis syndrome. Conclusion Evidence for the effectiveness of acupuncture for musculoskeletal disorders of the extremities was inconsistent. Traditional needle acupuncture may be beneficial for CTS and Achilles tendinopathy, but not for nonspecific upper extremity pain and patellofemoral syndrome. Electroacupuncture may be effective for shoulder injuries and may show similar effectiveness to that of night wrist splinting for CTS. The effectiveness of dry needling for plantar fasciitis is equivocal. Level of Evidence Therapy, 1a-. J Orthop Sports Phys Ther 2016;46(6):409-429. Epub 26 Apr 2016. doi:10.2519/jospt.2016.6270.
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5.
Remote Ischemic Preconditioning and Contrast-Induced Nephropathy: A Systematic Review.
Koch, C, Chaudru, S, Lederlin, M, Jaquinandi, V, Kaladji, A, Mahé, G
Annals of vascular surgery. 2016;:176-87
Abstract
BACKGROUND The use of imaging is increasing in clinical practice either for diagnosis or intervention. In these aims, contrast medium (CM) is widely used. However, CM administration can induce contrast-induced nephropathy (CIN). The incidence of CIN varies from 2% to 50% depending on patient risk factors, and CIN is the third cause of renal insufficiency. To date, methods such as hyperhydration to prevent CIN have a low level of evidence. Remote ischemic preconditioning (RIPC), which has already proved its efficiency in the cardiology field, seems to be a promising technique for CIN prevention. The aim of this work was to carry out a systematic review of the literature of the randomized clinical studies on RIPC in the prevention of CIN in man. METHODS We conducted a systematic review of randomized clinical studies on the RIPC in the prevention of CIN in man. Documentary sources were PubMed articles published until June 2015. Randomized clinical trials of RIPC in preventing CIN in human were reviewed. RESULTS Five articles were selected for the analysis. One article studied the impact of RIPC in a population at high risk of CIN, whereas the other 4 analyzed populations at low, moderate or unknown risk of CIN. In 4 studies, except the later one, the risk of CIN was based on the Mehran score that was previously published. In the high-risk population, a decrease in the incidence of CIN was found in the RIPC group compared with the control group (12% against 40%; P = 0.002). Among the 3 other studies using the Mehran's score, one also demonstrated the interest of such a procedure in a subgroup of high-risk patients. A second one found a low incidence of CIN in the RIPC group ([5 of 47; 10%] as compared with a control group [17 of 47; 36%] P = 0.003) in patients at the low risk of CIN. In another low-risk population, a significant lower level of a biological marker (liver-type fatty acid-binding protein) that assesses a renal impairment was found in the RIPC compared with the control group. CONCLUSIONS Only 5 studies were found in this search, which may constitute a limitation. However, RIPC appears as a promising method to prevent CIN since it is a noninvasive, low cost, easy, and safe method. More randomized controlled trials are needed to confirm these preliminary results.
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6.
Osteoporosis and upper extremity fragility fractures.
Foote, JE, Rozental, TD
The Journal of hand surgery. 2012;(1):165-7
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7.
Origins and application of bark cloth in upper extremity splinting.
Groth, GN, Kamwesiga, J
Journal of hand therapy : official journal of the American Society of Hand Therapists. 2002;(2):202-4