Síndrome del túnel del carpo: aspectos clínicos y su relación con los factores ocupacionales

Carpal tunnel syndrome is a condition of the hand most commonly seen in clinical practice. Many in the workforce, both men and women develop this condition and many say their workplace has caused their condition. Symptoms may be avoidable if good ergonomic practices are followed, and control of mechanical risk factors in the workplace can help the rehabilitation of the affected employee. But a direct relationship between the type of work performed and the development of this pathology has not yet been established, which leads to the conclusion that we still need more study and thus more evidence that establishes the STC as an occupational disease.A síndrome do túnel do carpo é uma condição da mão mais comumente visto na prática clínica. Muitas pessoas na força de trabalho, homens e mulheres irá desenvolver a doença e muitos dizem que o seu trabalho tem causado a sua condição. Os sintomas podem ser prevenidas, seguindo as boas práticas de ergonomia e controle de fatores de risco mecânicos no local de trabalho pode ajudar a reabilitação do empregado afetada. No entanto, ainda não está estabelecida uma relação directa entre o tipo de trabalho e para o desenvolvimento da doença, o que conduz à conclusão de que mais pesquisa é ainda necessária e, portanto, mais evidência de que estabelece a síndrome do túnel cárpico como uma doença profissional.El síndrome del túnel carpiano es una de las condiciones de la mano más comunes que se observan en la práctica clínica. Muchas personas en la fuerza de trabajo, tanto hombres como mujeres, desarrollarán dicha patología y muchos afirman que su lugar de trabajo ha causado su condición. Los síntomas pueden ser evitables si se siguen buenas prácticas ergonómicas, además el control de los factores de riesgo mecánicos en el lugar de trabajo puede ayudar a la rehabilitación del trabajador afectado. Sin embargo, todavía no se ha establecido una relación directa entre el tipo de trabajo realizado y el desarrollo de esta patología, lo que permite concluir que todavía hace falta más investigación y con ello más evidencia que establezca el Síndrome del Túnel del Carpo como una enfermedad profesional

Extorsión en Medellín ¿Qué es y cuáles son sus principales manifestaciones?. Comuna 2 Santa cruz, 5 Castilla, 15 Guayabal y 16 Belén

RESUMEN: La presente cartilla es una herramienta pedagógica para explicar de manera resumida qué es y cómo ocurre la extorsión en Medellín, un fenómeno que no es fácil de identificar para muchas personas y funcionarios públicos de la ciudad y del país. Hoy la extorsión, más que un delito, es la parte visible de problemas estructurales de la ciudad que no han sido atendidos adecuadamente por las instituciones oficiales y por las comunidades a lo largo de décadas. Por eso, el Sistema de Información para la Seguridad y la Convivencia (SISC) y el Observatorio de Seguridad Humana (OSH) analizaron la extorsión en cuatro comunas: 2 Santa Cruz, 5 Castilla, 15 Guayabal y 16 Belén, y la observaron como un fenómeno de regulación ilegal del orden social, de control de territorios y de disputas por el poder del Estado. En este sentido, la extorsión ocurre de manera diferencial por sectores y las afectaciones para las comunidades van más allá de lo económico.También se reconocen las iniciativas comunitarias y las formas en las que la gente vive o se resiste a este problema y a partir de allí se generan recomendaciones de actuación. Tomado de la presentación

Reduced Cancer Incidence in Huntington's Disease: Analysis in the Registry Study

Background: People with Huntington's disease (HD) have been observed to have lower rates of cancers. Objective: To investigate the relationship between age of onset of HD, CAG repeat length, and cancer diagnosis. Methods: Data were obtained from the European Huntington's disease network REGISTRY study for 6540 subjects. Population cancer incidence was ascertained from the GLOBOCAN database to obtain standardised incidence ratios of cancers in the REGISTRY subjects. Results: 173/6528 HD REGISTRY subjects had had a cancer diagnosis. The age-standardised incidence rate of all cancers in the REGISTRY HD population was 0.26 (CI 0.22-0.30). Individual cancers showed a lower age-standardised incidence rate compared with the control population with prostate and colorectal cancers showing the lowest rates. There was no effect of CAG length on the likelihood of cancer, but a cancer diagnosis within the last year was associated with a greatly increased rate of HD onset (Hazard Ratio 18.94, p < 0.001). Conclusions: Cancer is less common than expected in the HD population, confirming previous reports. However, this does not appear to be related to CAG length in HTT. A recent diagnosis of cancer increases the risk of HD onset at any age, likely due to increased investigation following a cancer diagnosis

Clinical and genetic characteristics of late-onset Huntington's disease

Background: The frequency of late-onset Huntington's disease (&gt;59 years) is assumed to be low and the clinical course milder. However, previous literature on late-onset disease is scarce and inconclusive. Objective: Our aim is to study clinical characteristics of late-onset compared to common-onset HD patients in a large cohort of HD patients from the Registry database. Methods: Participants with late- and common-onset (30–50 years)were compared for first clinical symptoms, disease progression, CAG repeat size and family history. Participants with a missing CAG repeat size, a repeat size of ≤35 or a UHDRS motor score of ≤5 were excluded. Results: Of 6007 eligible participants, 687 had late-onset (11.4%) and 3216 (53.5%) common-onset HD. Late-onset (n = 577) had significantly more gait and balance problems as first symptom compared to common-onset (n = 2408) (P &lt;.001). Overall motor and cognitive performance (P &lt;.001) were worse, however only disease motor progression was slower (coefficient, −0.58; SE 0.16; P &lt;.001) compared to the common-onset group. Repeat size was significantly lower in the late-onset (n = 40.8; SD 1.6) compared to common-onset (n = 44.4; SD 2.8) (P &lt;.001). Fewer late-onset patients (n = 451) had a positive family history compared to common-onset (n = 2940) (P &lt;.001). Conclusions: Late-onset patients present more frequently with gait and balance problems as first symptom, and disease progression is not milder compared to common-onset HD patients apart from motor progression. The family history is likely to be negative, which might make diagnosing HD more difficult in this population. However, the balance and gait problems might be helpful in diagnosing HD in elderly patients