scholarly journals Carpal tunnel syndrome: elastosonographic strain ratio andcross-sectional area evaluation for the diagnosis and disease severity.

2016 ◽  
Vol 18 (3) ◽  
pp. 305 ◽  
Author(s):  
Idil Gunes Tatar ◽  
Aydin Kurt ◽  
NeseGungor Yavasoglu ◽  
Baki Hekimoglu
Keyword(s):  
Carpal Tunnel ◽  
Strain Ratio ◽  
Change Score ◽  
Ratio Score ◽  
Sectional Area ◽  
Tunnel Syndrome ◽  
Group 3 ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Aim: To evaluate the role of gray scale ultrasonography (US) and real time elastosonography (RTE) incarpal tunnel syndrome (CTS). Materials and methods: Both wrists of 18 healthy volunteers (n=36) formed the control group (Group 1) and 19 symptomatic outpatients of the neurology clinic constituted the patient group. According to nerve conduction study results, cases with mild CTS (n=15) formed Group 2; cases with moderate to severe CTS (n=20) formed Group 3. Cross sectional area (CSA) and strain ratio (SR) were measured at carpal tunnel inlet (CTI) and 4 cm proximal to the distal end of the radius (P). CSA and SR change score (CSACTI-CSAP; SRCTI-SRP), CSA and SR ratio score (CSACTI / CSAP; SRCTI / SRP) were calculated. Results: The median nerve was significantly stiffer in Group 2 compared to Group 1; also in Group 3 compared to Group 1 (p=0.000). For CSACTI, the difference was significant between Group 1 and Group 3 (p=0.000), also between Group 2 and Group 3 (p=0.001). For CSA change scores the difference was only significant between Group 1 and Group 3 (p=0.015). In the diagnosis of CTS the best cut-off value for CSACTI was 10.8 (p=0.001), 2.3 for SRCTI(p=0.000), 4.9 for the CSA change score (p=0.005), 0.05 for the SR change score (p=0.000), 1.3 for the the CSA ratio score (p=0.015) and 1.1 for the SR ratio score (p=0.000). Conclusion: SR measurements do not  exclude patients even with mild CTS but cannot categorize disease severity. CSA measurements on the other hand can categorize disease severity.Therefore, the combined use of US and RTE is suggested.

The Use of Ultrasonography in Detection of Synovitis in Carpal Tunnel Syndrome

1993 ◽  
Vol 18 (2) ◽  
pp. 176-179 ◽  
Author(s):  
K. NAKAMICHI ◽  
S. TACHIBANA
Keyword(s):  
Rheumatoid Arthritis ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Lymphocytic Infiltration ◽  
Idiopathic Carpal Tunnel Syndrome ◽  
Tunnel Syndrome ◽  
Group 3 ◽  
Group 2 ◽  
Inflammation Group ◽  
Group 1

The findings of pre-operative ultrasonography of the carpal tunnel were compared with synovial histology in 50 surgically treated wrists with carpal tunnel syndrome. Eight wrists with a massive hypoechoic area (group 3) had synovitis. 28 with a minimal hypoechoic area (group 1) had no evidence of inflammation. 14 with a moderately increased hypoechoic area (group 2) consisted of three with synovitis, four with lymphocytic infiltration and seven without inflammation. Group 3 strongly indicates synovitis, in which case one should consider aetiology other than the idiopathic cause. Bilateral synovial thickening suggests carpal tunnel syndrome as the initial clinical picture of rheumatoid arthritis, and group 1 indicates idiopathic carpal tunnel syndrome provided that there are no primary causes.

scholarly journals Efficacy of Hyalase Hydrodissection in the Treatment of Carpal Tunnel Syndrome: A Randomized, Double-Blind, Controlled, Clinical Trial

2020 ◽  
Vol 2;23 (4;2) ◽  
pp. E175-E183
Author(s):  
Emad Zarief Kamel
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Saline Solution ◽  
Controlled Clinical Trial ◽  
Tunnel Syndrome ◽  
Group 2 ◽  
Group 1

Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, which results from median nerve compression. A lot of nonsurgical modalities are available for the management of mild to moderate situations. Local Hyalase hydrodissection (HD) of the entrapped median nerve could offer a desirable sustained symptom alleviation. Objectives: To evaluate the clinical efficacy of Hyalase/saline solution carpal tunnel HD on pain, functional status, and nerve conduction in patients with CTS. Study Design: A randomized, double-blinded trial. Setting: Anesthesia, pain, and rheumatology clinics in a university hospital. Methods: Patients: 60 patients with CTS (> 6 months’ duration). Intervention: patients were allocated equally into either group 1 (HD with Hyalase + 10 mL saline solution injection), or group 2 (HD with 10 mL saline solution only). Measurements: assessment of pain using Visual Analog Scale (VAS), functional disability (FD) score, and nerve conduction studies before injection, and over 6 months after injection. Nerve conduction parameters before injection and postinjection by the end of 3 and 6 months were evaluated as well. Results: Statistically significant lower postinjection values of VAS (1 ± 1.8, 2 ± 1.1, 2 ± 1.2, 2 ± 1.1) in group 1 versus (2 ± 1.2, 3 ± 1.7, 4 ± 1.5, 5 ± 2.6) in group 2 by the end of the first week, and the first, third, and sixth months, and significantly lower FD scores (15.3 ± 1.2, 13 ± 1.3, 10.2 ± 1.3, 10.2 ± 1.3) in group 1 versus (17.5 ± 1.8, 16.6 ± 2.8, 19.4 ± 3.2, 21.2 ± 2.5) in group 2 during the same time intervals. Nerve conduction study parameters have shown significantly higher velocity and lower latency in the Hyalase group than in the saline solution group by the 3 and 6 month follow-up. Limitation: We suggest a longer period could be reasonable. Conclusions: Carpal tunnel HD with Hyalase with saline solution is considered as an efficient technique offering a rapid onset of pain relief and functional improvements, and better median nerve conduction in patients with CTS over 6 months follow-up duration. Key words: Carpal tunnel syndrome, Hyalase, median nerve hydrodissection

scholarly journals The Effectiveness of Endoscopic Surgery of Juvenile Angiofibroma Using Surgical Glue

2020 ◽  
Vol 8 (B) ◽  
pp. 150-154
Author(s):  
Seyed-Hadyi Samimi Ardesan ◽  
Mojtaba Mohammadi Ardehali ◽  
Najmeh Doustmohammadian
Keyword(s):  
Blood Loss ◽  
Endoscopic Surgery ◽  
Tumor Staging ◽  
Low Cost ◽  
Tumor Stage ◽  
Nasopharyngeal Angiofibroma ◽  
Group 3 ◽  
The Difference ◽  
Group 2 ◽  
Group 1

AIM: The current study aimed to provide a method for juvenile nasopharyngeal angiofibroma embolization using Glubran glue in patients with low stage tumor. This method not only has less blood loss and good visualization but also impose a low cost, where no pre-operative embolization complications were found for this procedure. METHODS: Between 2012 and 2014, 30 patients with angiofibroma undergoing endoscopic surgery. Age, sex, tumor stage, average blood loss, complications, length of hospitalization, and recurrence rate of the tumor were the main measured outcomes. Furthermore, 30 patients were divided into three groups with matched age, sex, and tumor staging. Group 1 received glue (Glubran), while Group 2 selected for study without glue and embolization and pre-operative embolization was considered for Group 3. RESULTS: Based on the amount bleeding, the mean blood hemorrhage in Groups 1, 2, and 3 was 510, 1655, and 800 ml, respectively, the difference of hemorrhage between Groups 1 and 2 was found to be statistically significant (p = 0.007). Blood loss in Group 1 was found to be less than Group 3, but the difference of hemorrhage between Group 1 and 3 was not statistically significant (p = 0.678). No blood transfusion and complication were recorded for individuals in Group 1. The recurrence was found in 1 patient (10%) in both groups of 2 and 3, and no patient (0%) in Group 1. CONCLUSIONS: The direct intraoperative embolization technique with glue was capable of providing a more complete and targeted embolization of the tumor. Some advantages can be mentioned for this technique, including decreased blood loss, less radiation exposure, lower rates of complications, and recurrence, as well as shorter hospitalization time, the ease of procedure with a spinal needle and low cost.

scholarly journals Plasma as an indicator of bone fluoride levels in rats chronically exposed to fluoride

2006 ◽  
Vol 14 (4) ◽  
pp. 238-241 ◽  
Author(s):  
Juliane Guimarães de Carvalho ◽  
Rodrigo Cardoso de Oliveira ◽  
Marília Afonso Rabelo Buzalaf
Keyword(s):  
Wistar Rats ◽  
Direct Method ◽  
Facilitated Diffusion ◽  
Bone Surface ◽  
Male Wistar Rats ◽  
Group 3 ◽  
The Difference ◽  
Group 2 ◽  
Exposure Methods ◽  
Group 1

OBJECTIVE: This study evaluated the use of plasma, bone surface (periosteal) and whole bone as biomarkers of chronic fluoride (F) exposure. METHODS: Forty male Wistar rats were assigned to 4 groups (n=10/gr) that differed according to the F concentration they received in the drinking water. Groups 1, 2, 3 and 4 received water containing 0 (control), 5, 15, and 50 mg F/L, respectively. The rats were killed at 120 days of age. Plasma and femur were collected and analyzed for fluoride with the ion specific electrode by the direct method or after hexamethyldisiloxane-facilitated diffusion. Data were tested for statistically significant differences by ANOVA and linear regression (p<0.05). RESULTS: Mean (± SE) plasma F concentrations ranged from 0.030 ± 0.002 to 0.187 ± 0.013 (mg/mL). The concentrations in surface and whole bone ranged from 610 ± 32 to 4,693 222; and 647 ± 22 to 3,439 ± 134 µg/g, respectively. The surface/whole F concentration ratios were 0.941, 1.414, 1.173 and 1.377, for groups 1, 2, 3 and 4 respectively. For plasma and whole bone, the difference among all groups was statistically significant, except for group 2 compared to group 1. For bone surface, all groups differed from each other except for group 2 compared to group 3. A significant positive correlation was found between bone surface and whole bone F (r²=0.94), as well as between plasma and bone surface (r²=0.71) and plasma and whole bone (r²=0.74). CONCLUSIONS: Data suggest that both bone surface and whole bone are suitable biomarkers of chronic F exposure in rats and plasma may be used as indicator of bone fluoride levels.

scholarly journals Evaluation of the Clinical Efficacy of Using Thermal Camera for Cryotherapy in Patients with Total Knee Arthroplasty: A Prospective Study

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 661 ◽  
Author(s):  
Zekeriya Okan Karaduman ◽  
Ozan Turhal ◽  
Yalçın Turhan ◽  
Zafer Orhan ◽  
Mehmet Arican ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Postoperative Period ◽  
Thermal Camera ◽  
Prosthesis Infection ◽  
Total Knee ◽  
Group 3 ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Background and objectives: Cryotherapy is a method of treatment using cold application. This study aimed to evaluate postoperative clinical and hematological parameters and pain associated with total knee arthroplasty in patients and compared cryotherapy to the conventional method of cold ice pack compressions. Materials and Methods: Between January 2015 and January 2016, 90 patients who underwent total knee arthroplasty for grade 4 gonarthrosis were prospectively evaluated. The patients were divided into three groups (n = 30, each): Group 1, cryotherapy was applied in the pre- and postoperative periods; Group 2, cryotherapy was applied only in the postoperative period; and Group 3 (control group), only a cold pack (gel ice) was applied postoperatively. In all groups, pre- and postoperative evaluations at 6, 24, and 48 h, hemorrhage follow-up, knee circumference measurement, visual analog scale pain score, knee circumference, and temperature measured by thermal camera were recorded. Results: Of the 90 patients, 10% were men and 90% were women. The mean age was 64.3 ± 8.1 (range: 46–83) years. The patella upper end diameter values were significantly lower in the postoperative period in Groups 1 and 2 than in Group 3 (p = 0.003). Hemoglobin levels at 24 and 48 h postoperatively were significantly lower in Group 3 than in Group 1 (p < 0.001, each) and Group 2 (p = 0.038, p < 0.001). At 6, 24, and 48 h follow-ups, pain values were significantly lower in Group 2 than in Group 3 (p < 0.001). Preoperative 6, 24, and 48 h temperature values were significantly lower in Group 1 than in Group 3 (p < 0.001 for each). It was found that the difference between preoperative and postoperative knee flexion measurements was significantly different in both groups or the difference between the groups was changed in each period (p < 0.001). Conclusions: Postoperative cryotherapy is a potentially simple, noninvasive option and beneficial for the reduction of reducing pain, bleeding, length of stay, analgesic requirement and swelling after total knee arthroplasty. Moreover, there was no early or late prosthesis infection in cryotherapy groups, which may be considered as an additional measure to prevent prosthesis infection.

An outbreak of oriental theileriosis in dairy cattle imported to Vietnam from Australia

Parasitology ◽  
2016 ◽  
Vol 144 (6) ◽  
pp. 738-746 ◽  
Author(s):  
HAGOS GEBREKIDAN ◽  
LINDA NELSON ◽  
GREG SMITH ◽  
ROBIN B. GASSER ◽  
ABDUL JABBAR
Keyword(s):  
Dairy Cattle ◽  
Phylogenetic Analyses ◽  
Surface Protein ◽  
Theileria Orientalis ◽  
Group 3 ◽  
Cattle Blood ◽  
The Difference ◽  
Group 2 ◽  
Major Piroplasm Surface Protein ◽  
Group 1

SUMMARYThis study reports an outbreak of oriental theileriosis in dairy cattle imported to Vietnam from Australia. Following clinical and pathological diagnoses, a total of 112 cattle blood samples were divided into three groups and tested using multiplexed tandem PCR. Group 1 were from aborted heifers in Vietnam; group 2 were from cattle before shipment from group 1 cattle and group 3 were from the same batch of cattle but transported to Taiwan. Theileria orientalis DNA was detected in 72·3% cattle. The prevalences of T. orientalis in groups 1, 2 and 3 were 77·6, 86·9 and 57·5%, respectively, and the difference in prevalence was significant between groups 1 and 3 (P < 0·0001). The infection intensities of genotypes chitose and ikeda of T. orientalis were higher in groups 1 (57 721 and 33 709, respectively) and 3 (5897 and 61 766, respectively) than those in group 2 (2071 and 6331, respectively). Phylogenetic analyses of the major piroplasm surface protein sequences revealed that genotypes chitose and ikeda determined herein were closely related to those previously reported from Australia. This first report of an outbreak of oriental theileriosis in imported cattle emphasizes improved measures for the export and import of cattle infected with T. orientalis.

Single versus repetitive injection of lignocaine in the management of carpal tunnel syndrome – a randomized controlled trial

2014 ◽  
Vol 40 (2) ◽  
pp. 179-183 ◽  
Author(s):  
S. Akarsu ◽  
Ö. Karadaş ◽  
F. Tok ◽  
H. Levent Gül ◽  
E. Eroğlu
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Controlled Trial ◽  
Post Treatment ◽  
Randomized Controlled ◽  
Electrophysiological Findings ◽  
Tunnel Syndrome ◽  
Group 2 ◽  
Single Versus ◽  
Group 1

The aim of this study was to determine the efficacy of single versus repetitive injection of lignocaine into the carpal tunnel for the management of carpal tunnel syndrome. The 42 patients included were randomly assigned to two Groups: group 1 was injected with 4 mL of 1% lignocaine once and Group 2 was injected with 4 mL of 1% lignocaine twice a week for 2 weeks. Clinical and electrophysiological evaluations were performed at the study onset, and at 6 and 12 weeks following the final injection. Initially, the groups were similar with respect to clinical and electrophysiological findings. All parameters in Group 2 improved 6 weeks post treatment ( p < 0.05), and these improvements persisted at 12 weeks post treatment ( p < 0.05). Repetitive local lignocaine injection was effective in reducing the symptoms of carpal tunnel syndrome and improving electrophysiological findings.

scholarly journals Correlation of invitro susceptibility based on MICs and SQLE mutations with clinical response to terbinafine in patients with tinea corporis/cruris

2018 ◽  
Author(s):  
Ananta Khurana ◽  
Aradhana Masih ◽  
Anuradha Chowdhary ◽  
Kabir Sardana ◽  
Sagar Borker ◽  
...  
Keyword(s):  
Clinical Response ◽  
Drug Exposure ◽  
Antifungal Susceptibility ◽  
Tinea Corporis ◽  
Squalene Epoxidase ◽  
Improved Outcomes ◽  
Group 3 ◽  
The Difference ◽  
Group 2 ◽  
Group 1

ABSTRACTRecalcitrant dermatophytoses are on the rise and recent publications have documented high minimum inhibitory concentrations (MICs) to TRB and squalene epoxidase (SQLE) mutations. However, literature correlating the laboratory the data with clinical response is lacking.This study was conducted to study the clinico-mycological profile of tinea corporis and cruris, including antifungal susceptibility testing (AFST) and SQLE mutation analysis and correlate these with clinical response to TRB. Skin scrapings of patients with tinea corporis with/without tinea cruris were subjected to species identification, AFST and SQLE gene analysis (on 15 isolates). KOH confirmed cases were started on TRB 250mg once a day (OD). If >50% clinical clearance was achieved by 3 weeks; the same dose was continued.(Group 1). If clinical clearance at 3 weeks was <50%, the dose was increased to 250mg twice a day (BD) (Group 2). If the response still remained below 50% after 3 weeks of BD, the patients were treated with itraconazole (ITR)(Group 3). Trichophyton interdigitale was confirmed on all 64 isolates obtained on culture. Forty four (68.7%) isolates had high (≥1 μg/ml) MICs to TRB. Six isolates were found to have aminoacid substitution Leu393Phe in SQLE protein, while one had the substitution Phe397Leu. The difference in modal MICs to TRB between the 3 clinical response groups (1.5157μg/ml, 5.0396 μg/ml and 20.1587μg/ml respectively for group 1,2 and 3) was highly significant. Clinical response was achieved in 68% of those resistant by MIC data, and 42.8% of SQLE mutation harboring isolates, by increasing drug (TRB) exposure.We infer that TRB resistance in dermatophytes has reached alarming proportions in our patients. Though improved outcomes were achieved with higher drug exposure, with the high failure rate seen in the study, the case for shifting to another class of antifungals as first line agent against dermatophytoses is strong.

scholarly journals Parasitemia of Male White Mice (Mus musculus L.) DDY Strain Infected with Trypanosoma evansi Pidie and Pemalang Isolate

2014 ◽  
Vol 10 (2) ◽  
Author(s):  
Febiola Rama Sari ◽  
Yudha Fahrimal ◽  
Ummu Balqis ◽  
Didik T Subekti ◽  
Aprilia Wardana
Keyword(s):  
Treatment Group ◽  
Trypanosoma Evansi ◽  
Rapid Rise ◽  
Treatment Groups ◽  
Parasitemia Level ◽  
Group 3 ◽  
The Difference ◽  
Group 2 ◽  
Short Time ◽  
Group 1

This study aimed to find out the parasitemia of DDY white mice infected with T. evansi of Pidie and Pemalang isolates obtained from Bbalitvet Bogor. A total of 12 mice were divided into 3 treatment groups. Group 1 (K1) without any treatment, group 2 (K2) was inoculated with 104 T. evansi Pidie isolate, and group 3 (K3) was inoculated with 104 T. evansi Pemalang isolate. Parasitemia examination was carried out every two days and the level of parasitemia was observed as well. Parasitemia examination was conducted until all mice died. Parasitemia of mice infected with Pidie isolate was characterized by rapid rise of parasitemia in blood (107-108/mL of blood) in a short time (2-4 days) since first parasitemia was detected and followed by death at day 4. The parasitemia of mice infected with Pemalang isolate increased in the blood (108-109/mL of blood) on day 4 and maintained for a few more days and then fluctuated for a few more days before the animal was dead. In conclusion, there was the difference in parasitemia level between Pidie and Pemalang isolates. Key words: Trypanosoma evansi, parasitemia, Pidie isolate, Pemalang isolate

scholarly journals Analysis of Instagram® Posts Referring to Cleft Lip

2020 ◽  
Vol 17 (20) ◽  
pp. 7404
Author(s):  
Magdalena Sycinska-Dziarnowska ◽  
Piotr Stepien ◽  
Joanna Janiszewska-Olszowska ◽  
Katarzyna Grocholewicz ◽  
Maciej Jedlinski ◽  
...  
Keyword(s):  
Congenital Anomaly ◽  
Social Media ◽  
Cleft Lip ◽  
Medical Information ◽  
Cleft Lip And Palate ◽  
Group 4 ◽  
Group 3 ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Background: Social media has become a source of medical information. Cleft lip and palate is a visible congenital anomaly. The aim of the study was to analyze Instagram® posts on the topic of cleft lip. Methods: Instagram® posts with “#cleftlip” from March 2014–March 2017 were accessed. Separate lists of expressions (hashtags, meaningful words, words with emojis or emojis alone) were prepared for primary posts and for replies. Thirty expressions statistically most frequent in primary versus secondary posts and 30 in secondary versus primary posts were identified (Group 1) as well as 30 English words or hashtags (Group 2), non-English words or hashtags (Group 3) and emojis (Group 4). The frequencies of expressions were compared (Z-test for the difference of two population proportions). Results: There were 34,129 posts, (5427 primary posts and 28,702 replies), containing 62,163 expressions, (35,004 in primary posts). The occurrence of all expressions was 454,162, (225,418 in primary posts and 228,744 in replies). Posts with positive expressions such as “beautiful”, “love”, “cute”, “great”, “awesome” occurred more often than these with negative ones. In replies all emojis were positive. Conclusions: Numerous Instagram® posts referring to cleft lip are published and do provoke discussion. People express their solidarity and sympathize with persons affected by cleft.

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