scholarly journals IS THERE A CROSS-TALK BETWEEN UPPER LIMB CLAUDICATION AND HAND STRENGTH IN TAKAYASU ARTERITIS?

2019 ◽  
Author(s):  
ALEXANDRE MOURA SANTOS ◽  
RAFAEL GIOVANI MISSÉ ◽  
ISABELA BRUNA PIRES BORGES ◽  
ROSA MARIA R PEREIRA ◽  
SAMUEL KATSUYUKI SHINJO
Keyword(s):  
Upper Limb ◽  
Cross Talk ◽  
Takayasu Arteritis ◽  
Hand Strength

scholarly journals Is there an association between upper limb claudication and handgrip strength in Takayasu arteritis?

Reumatismo ◽  
2021 ◽  
Vol 72 (4) ◽  
pp. 197-206
Author(s):  
A.M. Dos Santos ◽  
R.G. Misse ◽  
I.B.P. Borges ◽  
R.M.R. Pereira ◽  
S.K. Shinjo
Keyword(s):  
Blood Pressure ◽  
Upper Limb ◽  
Functional Capacity ◽  
Takayasu Arteritis ◽  
Handgrip Strength ◽  
Hand Strength ◽  
Clinical Activity ◽  
Physician Global Assessment ◽  
Vessel Imaging ◽  
Left Limb

Limb vascular claudication and hand muscle weakness are common symptoms of Takayasu arteritis (TAK). However, no studies have correlated these two symptoms. Therefore, the aim of the study was to evaluate handgrip strength and its correlation with both upper-limb vascular claudication and imaging of the vessels. This cross-sectional study compared 36 patients with TAK who were matched by age, gender, and body mass index with 36 individuals without TAK (CTR). Hand strength (assessed with handgrip dynamometer), functional capacity (Health Assessment Questionnaire, HAQ), upper-limb vascular claudication symptoms (patients’ selfreported form), and disease activity (Indian Takayasu Clinical Activity Score [ITAS] 2010; Physician Global Assessment [PGA], C-reactive protein, and erythrocyte sedimentation rate) were evaluated as well as vessel imaging (e.g., angiotomography or angioresonance) and blood pressure. The median age of the patients was 42.0 years (35.5-51.5 years), whereas the mean disease duration was 13.1±6.8 years. No patient had active disease. Compared to the CTR, the patients with TAK showed reduced strength in the left-hand (22.9±5.9 vs 26.3±5.6 kg; p=0.014) and increased HAQ scores [0.50 (0.12-0.87) vs 0.00 (0.00-0.00); p<0.001]. Both groups had comparable blood pressure. Among patients with TAK, lefthand strength was inversely correlated with HAQ (Spearman correlation: rho=–0.584; p<0.001) and positively correlated with right-hand strength (rho=0.644; p<0.001). Moreover, neither hand’s strengths in the patients were correlated with subclavian stenosis imaging, blood pressure or limb vascular claudication. The reduction of strength in the upper left limb is inversely related to the functional capacity (HAQ score) of TAK. This reduction appears unrelated to classical vascular claudication, vessel imaging or blood pressure.

scholarly journals Absent Bilateral Upper Limb Pulses in Middle Age Male? Takayasu Arteritis

2020 ◽  
Vol 6 (3) ◽  
Keyword(s):  
Blood Pressure ◽  
Gall Bladder ◽  
Upper Limb ◽  
Takayasu Arteritis ◽  
Middle Age ◽  
Anesthetic Management ◽  
Age Group ◽  
Pulseless Disease ◽  
Female Predominance ◽  
Large Vessels

Takayasu arteritis also termed as pulseless disease is a rare and chronic inflammatory arteritis of large vessels. It is manifested mainly in young age group between 10-40 years with a female predominance. Anesthetic management of these patients is challenging in view of fluctuation in blood pressure, intimal fibrosis and stenosis of major blood vessels and multiorgan involvement. Here we present a case of 55 year old male patient with bilateral absent upper limb pulses posted for emergency surgery in view of gall bladder perforation that was successfully managed under general anesthesia. Keywords: Takayasu; Chronic; Inflammatory.

A Marker-Based Mean Finite Helical Axis Model to Determine Elbow Rotation Axes and Kinematics in Vivo

2010 ◽  
Vol 26 (3) ◽  
pp. 305-315 ◽  
Author(s):  
Aaron Chin ◽  
David Lloyd ◽  
Jacqueline Alderson ◽  
Bruce Elliott ◽  
Peter Mills
Keyword(s):  
Upper Limb ◽  
Cross Talk ◽  
Functional Model ◽  
Helical Axis ◽  
Rotation Axes ◽  
Model Following ◽  
Flexion Extension ◽  
Analysis Models ◽  
Extension Axis

The predominance of upper-limb elbow models have been based on earlier lower-limb motion analysis models. We developed and validated a functionally based 2 degree-of-freedom upper-limb model to measure rotations of the forearm using a marker-based approach. Data were collected from humans and a mechanical arm with known axes and ranges of angular motion in 3 planes. This upper-limb model was compared with an anatomically based model following the proposed ISB standardization. Location of the axes of rotation relative to each other was determined in vivo. Data indicated that the functional model was not influenced by cross-talk from adduction-abduction, accurately measuring flexion-extension and pronation-supination. The functional flexion-extension axis in vivo is angled at 6.6° to the anatomical line defined from the humeral medial to lateral epicondyles. The pronation-supination axis intersected the anatomically defined flexion-extension axis at 88.1°. Influence of cross-talk on flexion-extension kinematics in the anatomical model was indicated by strong correlation between flexion-extension and adduction-abduction angles for tasks performed by the subjects. The proposed functional model eliminated cross-talk by sharing a common flexion axis between the humerus and forearm. In doing so, errors due to misalignment of axes are minimized providing greater accuracy in kinematic data.

scholarly journals Hand Strength Deficit in Patients with Neurogenic Thoracic Outlet Syndrome

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 874
Author(s):  
Alban Fouasson-Chailloux ◽  
Pauline Daley ◽  
Pierre Menu ◽  
Bastien Louguet ◽  
Guillaume Gadbled ◽  
...  
Keyword(s):  
Grip Strength ◽  
Upper Limb ◽  
Healthy Subjects ◽  
Thoracic Outlet Syndrome ◽  
Hand Strength ◽  
Diagnostic Process ◽  
Healthy Controls ◽  
Neurogenic Thoracic Outlet Syndrome ◽  
Hand Dynamometer ◽  
The Mean

Neurogenic thoracic outlet syndrome (NTOS) is a chronic painful and disabling condition. Patients complain about upper-limb paresthesia or weakness. Weakness has been considered one of the diagnostic criteria of NTOS, but objective comparisons to healthy controls are lacking. We compared the grip and the key pinch strengths between NTOS patients and healthy controls. Grip strength was evaluated with a hydraulic hand dynamometer and the key pinch with a pinch gauge. All the patients with NTOS completed a QuickDASH. We included prospectively 85 patients with NTOS, 73% female and 27% male. The mean age was 40.4 ± 9.6. They were compared to 85 healthy subjects, 77.6% female and 22.4% male. Concerning the grip, symptomatic hands of NTOS patients had significantly 30% less strength compared to control hands (p ≤ 0.001), and 19% less strength compared to asymptomatic hands (p = 0.03). Concerning the key pinch, symptomatic hands of patients with NTOS had significantly 19.5% less strength compared to control hands (p ≤ 0.001). Grip and key pinch strengths had a significant correlation with the QuickDASH (r = −0.515 and r = −0.403, respectively; p ≤ 0.001). Patients with NTOS presented an objective hand strength deficit compared to healthy controls. This deficit was significantly correlated to the upper-limb disability. These findings confirm the interest of hand strength evaluation in the diagnostic process of patients with NTOS.

scholarly journals THU0594 A CASE OF TAKAYASU’S ARTERITIS IN A PATIENT WITH TUBERCULOUS LYMPHADENITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 539.3-539
Author(s):  
T. Khan ◽  
N. Cleaton ◽  
T. Sheeran
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Heat Shock ◽  
Upper Limb ◽  
Takayasu Arteritis ◽  
Takayasu’S Arteritis ◽  
Tuberculous Lymphadenitis ◽  
Takayasu's Arteritis ◽  
Cervical Lymph Nodes ◽  
History Of ◽  
The Relationship

Background:Takayasu’s arteritis (TA) is a large vessel vasculitis that principally affects the aorta and its main branches. The incidence has been reported at between 1.2 – 2.3 cases per million per year, more commonly in the Asian population. The age of onset is typically between tenth and fourth decade; between 80 and 90 percent of the cases are female.The relationship between Mycobacterium Tuberculosis (mTB) and TA has long been considered; both demonstrate chronic inflammatory changes on histological examination and some granuloma formation in arterial walls. There is increasing evidence implicating mTB in the pathogenesis of TA through molecular mimicry between the mycobacterium heat shock protein -65 (mHSP-65) and the human homologue HSP -60 (hHSP-60). However, no definitive link between the two diseases has been explained.Objectives:Case presentation.Results:A 23-year-old lady was referred to our outpatient rheumatology clinic with a twelve-month history of persistently enlarged cervical lymph nodes on the left side for which she had received six months of anti-Tuberculosis medication. She had been referred to the respiratory physicians who had diagnosed presumed Tuberculous Lymphadenitis, with caseating granulomas demonstrated on biopsy, positive acid-fast bacilli smear but a negative culture. The patient had been initiated six months of anti-Tuberculosis medication; however, her lymphadenopathy showed no improvement. More recently she described a five-month history of weakness, paraesthesia and claudication symptoms in her left upper limb with episodes of dizziness and blurred vision, episodes occurring 2-3 times per day and lasting between a few minutes to a few hours.Her examination at this presentation revealed an unrecordable blood pressure in the left upper limb and 104/67mmHg in the right. There was significant tender lymphadenopathy of the left cervical lymph nodes and diminished pulses in the left upper limb. Right sided pulses were normal. The rest of her examination was normal.Investigations at presentation revealed elevated inflammatory markers with C- reactive protein (CRP) of 116mg/dL and erythrocyte sedimentation rate (ESR) of 128mm/h. Complete blood count (CBC) found her to be anaemic with a haemoglobin of 100g/L, with a mean cell volume of 71.3fl, and have elevated platelet count of 649x 109/L. Recent computerized tomography scan with contrast of the thorax demonstrated features consistent with Takayasu Arteritis. Marked left subclavian stenosis was found on magnetic resonance imaging. High dose prednisolone at 60mg once daily along with Azathioprine 2mg/kg/day was started with a follow up appointment in two weeks.Conclusion:There is increasing evidence implicating mTB in the development of TA and a few cases recognising this link have been reported. We report a case of TA in a patient recently diagnosed and treated for Tuberculous lymphadenitis who then developed symptoms of TA. There should be a low threshold for suspecting a diagnosis of Takayasu’s arteritis in patients previously or actively infected with Mycobacterium Tuberculosis. Further research exploring the relationship between mTB and TA is required.References:[1]Espinoza JL, Ai S, Matsumura I. New Insights on the Pathogenesis of Takayasu Arteritis: Revisiting the Microbial Theory. Pathogens. 2018;7(3):73.[2]Aggarwal A, Chag M, Sinha N, et al. Takayasu’s arteritis: role of Mycobacterium tuberculosis and its 65 kDa heat shock protein. International Journal of Cardiology. 1996; 55: 49–55.[3]Reshkova V, Kalinova D, Rashkov R. Takayasu’s Arteritis associated with Tuberculosis Infections. Journal of Neurology and Neuroscience. 2016; 3:114.[4]Moritz K, Jansson Hilte F, Antje Kangowski, Christian Kneitz, Emil C. Reisinger. Tuberculosis and Takayasu arteritis: case-based review Rheumatology International 2019 39:345–351[5]D Misra, A Wakhlu, V Agarwal, D Danda. Recent advances in the management of Takayasu arteritis International Journal of Rheumatic Diseases 2019; 22: 60–68Disclosure of Interests:None declared

Reflex Responses in Upper Limb Muscles to Cutaneous Stimuli

1993 ◽  
Vol 20 (04) ◽  
pp. 271-278 ◽  
Author(s):  
R. Chen
Keyword(s):  
Stimulus Intensity ◽  
Upper Limb ◽  
Healthy Subjects ◽  
Voluntary Contraction ◽  
Cutaneous Reflexes ◽  
Focal Lesions ◽  
Normal Ranges ◽  
Conduction Velocities ◽  
Limb Muscles ◽  
Biphasic Responses

ABSTRACT:Cutaneous reflexes in the upper limb were elicited by stimulating digital nerves and recorded by averaging rectified EMG from proximal and distal upper limb muscles during voluntary contraction. Distal muscles often showed a triphasic response: an inhibition with onset about 50 ms (Il) followed by a facilitation with onset about 60 ms (E2) followed by another inhibition with onset about 80 ms (12). Proximal muscles generally showed biphasic responses beginning with facilitation or inhibition with onset at about 40 ms. Normal ranges for the amplitude of these components were established from recordings on 22 arms of 11 healthy subjects. An attempt was made to determine the alterent fibers responsible for the various components by varying the stimulus intensity, by causing ischemic block of larger fibers and by estimating the afferent conduction velocities. The central pathways mediating these reflexes were examined by estimating central delays and by studying patients with focal lesions

Mangling upper limb injuries in industry

Injury ◽  
1999 ◽  
Vol 30 ◽  
pp. S
Author(s):  
D RING
Keyword(s):  
Upper Limb ◽  
Limb Injuries
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