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Self-reported symptoms of cold intolerance in workers with injuries of the hand.

ABSTRACT: Cold intolerance is a well-recognized complication of crushing injuries and amputations in the hand. These symptoms are usually thought to resolve within 2 years of injury. The objectives of our study were to determine the prevalence and course over time of self-reported symptoms of cold intolerance in workers with hand injuries. Files from a large worker's compensation carrier were randomly selected from index years 2, 4, 6, and 10 after a claim was made. Cohorts comprising cases with diagnostic codes corresponding to traumatic hand injuries and codes referring to non-trauma diagnoses in the hand were assembled for each of the years under consideration. A questionnaire was mailed to a total of 7,088 asking questions related to the symptom of cold intolerance. Twenty-five percent of the surveys were returned. Over 90% of trauma patients from all 4 years reported symptoms of cold intolerance. The rate of cold intolerance in the non-trauma group was between 59% and 69%. Individuals reporting cold intolerance indicated worsening over time in 50% of cases and improvement in only 9%. The severity of injury did not appear to be a factor in the development of cold intolerance. Symptoms of cold intolerance are highly prevalent in workers with significant hand injuries. Workers with non-trauma hand conditions also report a substantial prevalence of this symptom. The development of cold intolerance is not related to injury severity. The symptoms remain either static or deteriorate slightly over time. Improvement is experienced by less than 10% of patients.

SUBMITTER: Graham B

PROVIDER: S-EPMC2525881 | biostudies-other | 2008 Sep

REPOSITORIES: biostudies-other

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Immersion in Cold-Water Evaluation (ICE) and self-reported cold intolerance are reliable but unrelated measures.

Project description:Intolerance to the cold is common following peripheral nerve injury and surgery of the upper extremity. Despite its prevalence, the exact pathophysiology and natural history of this condition are not well understood. Subjective, self-report questionnaires have been created and validated as reliable measures of post-traumatic cold intolerance. The difficulty currently lies in assigning an objective measure to this predominantly subjective phenomenon. The present study evaluated the test-retest reliability of a proposed objective measure of cold intolerance, the Immersion in Cold-water Evaluation (ICE), and its correlation with subjective measures in healthy control subjects. Two age groups were also compared to investigate the effect of age on cold intolerance and temperature recovery. On two separate testing days, subjects completed three health-related questionnaires and submersed their dominant hands in cold water. The temperature of their second and fifth digits was monitored during recovery. Both the objective cold-provocation testing and the subjective self-report questionnaires were highly reliable albeit not significantly correlated. No significant temperature recovery trend was noted between the age groups. Post-traumatic cold intolerance is postulated to have both a vascular and neural etiology among other contributing causes. The protocol studied here was centered predominantly on the former etiology, examining peripheral blood flow and associated temperature recovery. This study established ICE as a reliable means to objectively measure cold response, supplementing information provided by previously validated self-report methods.

| S-EPMC2525883 | biostudies-other

A comparison between self-reported hand eczema and self-reported signs and symptoms of skin lesions indicating hand eczema.

Project description:BackgroundThe accuracy of self-reported hand eczema (HE) is currently unclear, and it is unknown how well self-reported signs and symptoms of skin lesions that indicate HE correlate with self-reported HE.ObjectivesTo correlate self-reported signs and symptoms of skin lesions on the hands with self-reported HE, to assess the sensitivity and specificity, and to suggest a definition for HE.MethodSeven hundred ninety-five (47.8%) of 1663 invited healthcare workers completed a digital questionnaire, and were asked to report if they experienced HE or any of the following skin signs/symptoms in past 11 months: scaling, erythema, fissures, vesicles, dryness, itch, stinging.ResultsHE during the past 11 months was reported by 11.9%. Of these, 91.4% reported at least one skin sign versus 32.3% of those without self-reported HE. The highest sensitivity and specificity were found for erythema (77.4% and 78.2%, respectively) and itch (78.5% and 78.6%, respectively), both separately and combined. The combination of ≥2 signs (erythema, scaling, fissures and vesicles) and itch, reached a sensitivity of 52.7% and specificity of 93.9%.ConclusionThe marked difference between self-reported HE and signs/symptoms highlights the importance of differentiating between data based on self-reported HE and signs/symptoms. As a first step towards diagnostic HE criteria, ≥2 signs combined with itch could be considered, but clinical studies are needed to verify the precision.

| S-EPMC9796092 | biostudies-literature

Fecal Calprotectin in Self-Reported Milk Intolerance: Not Only Lactose Intolerance.

Project description:The hypothesis is that inflammatory/allergic conditions should be considered in self-reported milk intolerance (SRMI) patients who test negative and/or are asymptomatic at Lactose Hydrogen Breath Test (LHBT). We analyzed fecal calprotectin (FCP) values in SRMI patients to investigate the frequency of a "positive" intestinal inflammation marker and its correlation with lactose tolerance/intolerance. Data from 329 SRMI patients were retrospectively analyzed; according to the positive/negative results (maldigester/digester) and the presence/absence of symptoms reported during LHBT (intolerant/tolerant), patients were divided into: 'lactose tolerants' (n. 104), 'maldigesters/intolerants' (n. 187), 'digesters/intolerants' (n. 38). FCP values were analyzed in all three subgroups. A percentage of SRMI patients complained of constipation (>15%), extraintestinal symptoms (>30% including anemia), multiple food hypersensitivity (7.6%) and had intraepithelial lymphocytic infiltration at duodenal biopsy (>50%). Over 50.0% showed FCP values above the normal limit. Lactose tolerants and maldigesters/intolerants had higher positivity frequencies (p < 0.0001, for both) and absolute values (p = 0.04, for maldigesters/intolerants) of FCP compared to digesters/intolerants. FCP was not useful to differentiate tolerant from intolerant subjects (AUC 0.58). Our data suggest the existence of an allergic/inflammatory pathogenetic mechanism in a subset of SRMI subjects. FCP results are in keeping with this hypothesis, even if they cannot differentiate lactose tolerant from intolerant patients.

| S-EPMC9962554 | biostudies-literature

Self-reported disease symptoms of stone quarry workers exposed to silica dust in Ghana.

Project description:Background and aimsUnderstanding the importance of using personal protective equipment (PPE) and the influence of work-post (working distance to main dust source-crusher) in stone quarries is vital for designing tailored interventions in minimizing workers' exposure to silica dust. Nonetheless, studies on silica dust and disease symptoms in Ghana are nascent. This study assessed how work-post and use of required PPE jointly influence exposure to silica dust and disease symptoms in Ghana.MethodsGeneralized linear models (complementary log-log regression) were fitted to cross-sectional survey data of 524 stone quarry workers in Ghana to assess the joint effect of work-post and PPE usage on self-reported disease symptoms while controlling for relevant compositional and contextual factors.ResultsStone quarry workers who work between 1-100 m and beyond 100 m from the crusher with the required PPE were 90% and 87% respectively less likely to report eye irritation compared with their counterparts who work between 1 and 100 m from the crusher without the required PPE. Individuals who work between 1-100 m and beyond 100 m from the crusher with the required PPE were 94% and 95% respectively less likely to report breathing difficulty compared with the reference group. Workers who work between 1-100 m and beyond 100 m from the crusher with the required PPE were 97% and 99% respectively less likely to report coughing compared with the reference group. Workers who work between 1-100 m and beyond 100 m from the crusher with the required PPE were 93% and 97% respectively less likely to report common cold compared with their counterparts who work between 1 and 100 m from the crusher without the required PPE.ConclusionThere are adverse health implications for people who work in silica dust polluted environments, suggesting the need for a national safety and health policy to target them.

| S-EPMC7534518 | biostudies-literature

Understanding Healthcare Workers Self-Reported Practices, Knowledge and Attitude about Hand Hygiene in a Medical Setting in Rural India.

Project description:AimTo describe self-reported practices and assess knowledge and attitudes regarding hand hygiene among healthcare workers in a rural Indian teaching hospital.SettingA rural teaching hospital and its associated medical and nursing colleges in the district of Ujjain, India.MethodThe study population consisted of physicians, nurses, teaching staff, clinical instructors and nursing students. Self-administered questionnaires based on the World Health Organization Guidelines on Hand Hygiene in Healthcare were used.ResultsOut of 489 healthcare workers, 259 participated in the study (response rate = 53%). The proportion of healthcare workers that reported to 'always' practice hand hygiene in the selected situations varied from 40-96% amongst categories. Reported barriers to maintaining good hand hygiene were mainly related to high workload, scarcity of resources, lack of scientific information and the perception that priority is not given to hand hygiene, either on an individual or institutional level. Previous training on the topic had a statistically significant association with self-reported practice (p = 0.001). Ninety three per cent of the respondents were willing to attend training on hand hygiene in the near future.ConclusionSelf-reported knowledge and adherence varied between situations, but hand hygiene practices have the potential to improve if the identified constraints could be reduced. Future training should focus on enhancing healthcare workers' knowledge and understanding regarding the importance of persistent practice in all situations.

| S-EPMC5053486 | biostudies-literature

Self-reported Food Intolerance in Korean Patients With Irritable Bowel Syndrome.

Project description:Background/aimsVarious foods trigger and/or worsen the symptoms of irritable bowel syndrome (IBS). However, Korean food-related gastrointestinal (GI) symptoms in IBS patients have not yet been investigated. This study aims to evaluate the prevalence of self-reported food intolerance in Korean IBS patients and determine the Korean food items and food groups perceived by patients to worsen their GI symptoms.MethodsWe recruited 393 study subjects, comprising 101 IBS patients, 167 symptomatic non-IBS subjects, and 125 control subjects. All participants completed a questionnaire to identify the most problematic foods and assess the occurrence of GI symptoms caused by 119 Korean food items. They also completed the validated Rome III questionnaire for IBS.ResultsThe prevalence of self-reported food intolerance in Korean IBS patients was 79.2%, which was significantly higher than that in control subjects (44.8%, P < 0.001). The most problematic foods reported by IBS patients who experienced food intolerance were high-fat foods (25.0%), gluten foods (23.8%), spicy foods (15.0%), and dairy products (15.0%). A total of 63.4% of IBS patients reported GI symptoms related to the consumption of foods high in fermentable oligo-, di-, mono-saccharides, and polyols (FODMAP), while 48.5% of IBS patients reported symptoms associated with high-fat foods. Gas problems and loose stools were the most frequently reported symptoms.ConclusionsA large proportion of Korean IBS patients complained of intolerance to certain food items, with high-fat and high-FODMAP foods being the main triggers. This study provides a basis for planning food intervention studies for Korean IBS patients.

| S-EPMC6474711 | biostudies-literature

Association between self-reported signs and symptoms and SARS-CoV-2 antibody detection in UK key workers.

Project description:BackgroundScreening for SARS-CoV-2 antibodies is under way in some key worker groups; how this adds to self-reported COVID-19 illness is unclear. In this study, we investigate the association between self-reported belief of COVID-19 illness and seropositivity.MethodsCross-sectional study of three key worker streams comprising (A) Police and Fire & Rescue (2 sites) (B) healthcare workers (1 site) and (C) healthcare workers with previously positive PCR result (5 sites). We collected self-reported signs and symptoms of COVID-19 and compared this with serology results from two SARS-CoV-2 immunoassays (Roche Elecsys® and EUROIMMUN).ResultsBetween 01 and 26 June, we recruited 2847 individuals (Stream A: 1,247, Stream B: 1,546 and Stream C: 154). Amongst those without previous positive PCR tests, 687/2,579 (26%) reported belief they had COVID-19, having experienced compatible symptoms; however, only 208 (30.3%) of these were seropositive on both immunoassays. Both immunoassays had high sensitivities relative to previous PCR positivity (>93%); there was also limited decline in antibody titres up to 110 days post symptom onset. Symptomatic but seronegative individuals had differing symptom profiles and shorter illnesses than seropositive individuals.ConclusionNon-COVID-19 respiratory illness may have been mistaken for COVID-19 during the outbreak; laboratory testing is more specific than self-reported key worker beliefs in ascertaining past COVID-19 disease.

| S-EPMC7997203 | biostudies-literature

Self-reported dietary fructose intolerance in irritable bowel syndrome: Proposed diagnostic criteria.

Project description:AimTo study the criteria for self-reported dietary fructose intolerance (DFI) and to evaluate subjective global assessment (SGA) as outcome measure.MethodsIrritable bowel syndrome (IBS) patients were randomized in an open study design with a 2 wk run-in on a habitual IBS diet, followed by 12 wk with/without additional fructose-reduced diet (FRD). Daily registrations of stool frequency and consistency, and symptoms on a visual analog scale (VAS) were performed during the first 4 wk. SGA was used for weekly registrations during the whole study period. Provocation with high-fructose diet was done at the end of the registration period. Fructose breath tests (FBTs) were performed. A total of 182 subjects performed the study according to the protocol (88 FRD, 94 controls).ResultsWe propose a new clinically feasible diagnostic standard for self-reported fructose intolerance. The instrument is based on VAS registrations of symptom relief on FRD combined with symptom aggravation upon provocation with fructose-rich diet. Using these criteria 43 of 77 patients (56%) in the present cohort of IBS patients had self-reported DFI. To improve the concept for clinical evaluation, we translated the SGA scale instrument to Norwegian and validated it in the context of the IBS diet regimen. The validation procedures showed a sensitivity, specificity and κ value for SGA detecting the self-reported DFI group by FRD response within the IBS patients of 0.79, 0.75 and 0.53, respectively. Addition of the provocation test yielded values of 0.84, 0.76 and 0.61, respectively. The corresponding validation results for FBT were 0.57, 0.34 and -0.13, respectively.ConclusionFRD improves symptoms in a subgroup of IBS patients. A diet trial followed by a provocation test evaluated by SGA can identify most responders to FRD.

| S-EPMC4427694 | biostudies-literature

Self-reported musculoskeletal symptoms among dentists in Saudi Arabia.

Project description:Musculoskeletal disorders are very common in the dental practice. This cross-sectional study assessed the nature and prevalence of musculoskeletal symptoms (MS) and their associated risk factors among dentists in three types of clinics in Riyadh. A structured, self-administered questionnaire about demographic characteristics, nature of work, and prevalence and frequency of MS was completed by 274 male and 241 female dentists. Chi-square and logistic regression were used to determine the association of MS with a number of important variables. Pain in the lower back (64%) and neck (60%) were the most prevalent MS. Working in the dental colleges' clinics was associated with increased risk of MS (adjusted OR 2.30, 95% CI 1.27-4.18). A stronger association was observed for dentists working in the private clinics (adjusted OR 2.58, 95% CI 1.28-5.17) compared to government clinics. Female dentists were at more risk of MS than the male dentists (OR 1.63, 95%CI 1.02-2.59). The OR of MS for dentists treating more than 10 patients/d was 1.53 (95%CI 0.83-2.81). The higher risk of reported MS in females and for those working in the dental colleges and private clinics underscores the importance of recognition and prevention of MS even early in the dental profession.

| S-EPMC5546842 | biostudies-other

Whole Cow's Milk but Not Lactose Can Induce Symptoms in Patients with Self-Reported Milk Intolerance: Evidence of Cow's Milk Sensitivity in Adults.

Project description:BackgroundLactose intolerance is the most frequent food intolerance, but many subjects with self-reported milk intolerance (SRMI) are asymptomatic at lactose hydrogen breath test (LHBT). The aim of this study was to evaluate the frequency of lactose intolerance in SRMI patients and their clinical characteristics.MethodsIn a retrospective study, the clinical records of 314 SRMI patients (259 females, mean age: 39.1 ± 13.5 years) were reviewed; 102 patients with irritable bowel syndrome (IBS) served as controls. In a prospective study, 42 SRMI patients, negatives at the LHBT, underwent a double-blind, placebo-controlled (DBPC) whole cow's milk challenge.ResultsIn the retrospective study, only 178 patients (56%) were lactose maldigesters and intolerant at LHBT; 68% of the subjects with SRMI were suffering from IBS; 74% reported dyspepsia (p = 0.0001 vs. IBS controls); and weight loss was recorded in 62 SRMI patients (20%) (p = 0.01 vs. IBS controls). Duodenal histology showed intra-epithelial lymphocytosis in about 60% of cases. In the prospective study, 36 patients (86%) experienced symptoms during the DBPC cow's milk challenge, and only 4 patients (9%) reacted to placebo (p = 0.0001).ConclusionsA percentage of SRMI patients were not suffering from lactose intolerance. DBPC revealed that SRMI patients had clinical reactions when exposed to whole cow's milk.

| S-EPMC8621065 | biostudies-literature

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