Extensor indicis brevis muscle: an unusual muscular variant / Músculo extensor corto del índice: una inusual variación muscular

Knowledge of anatomical variations of the musculoskeletal system is important for interpreting unusual clinical presentations. We observed the presence of an abnormal extensor indicis muscle in the left hand of an adult male cadaver. In this case, the muscle comes from the ligament and over the scaphoideum and trapezoideum bones and continues after the short muscle belly; it is attached to the dorsal aponeurosis of the indicis. This muscular disposition was described in other studies which demonstrated approximately 1.0 percent of incidence. Clinically, this anatomical variation may be associated with pain and swelling at the back of the hand. In these cases symptoms tend to increase due to mechanical stress and can be confused with the presence of a dorsal synovial cyst. This report will help clinicians, surgeons, occupational and physical therapists formulate better clinical or surgical decisions when presented with a rare anatomical variation...

El conocimiento de las variaciones anatómicas del aparato locomotor es importante para la interpretación de las presentaciones clínicas inusuales. En este trabajo se relata la presencia de un músculo extensor indicis anormal en la mano izquierda de un cadáver de un hombre adulto, de sexo masculino. En este caso, el músculo proviene del ligamento y del dorso de los huesos escafoides y trapecio y se continúa después de un corto vientre muscular, fijándose a la aponeurosis dorsal del índice. Esta disposición muscular se ha descrito en otros estudios que demostraron aproximadamente un 1,0 por ciento de incidencia. Clínicamente, esta variación anatómica puede estar asociada con dolor e hinchazón en el dorso de la mano. En estos casos, los síntomas tienden a aumentar debido a la tensión mecánica y puede confundirse con la presencia de un quiste sinovial dorsal. Este informe ayudará a los médicos, cirujanos, terapeutas ocupacionales y físicos a tomar mejores decisiones clínicas o quirúrgicas cuando se le presenta una variación anatómica como la descrita...

Análise da dose do laser de baixa potência em equipamentos nacionais / Analysis of low-level laser therapy doses in Brazilian equipment

CONTEXTUALIZAÇÃO: A laserterapia de baixa potência vem sendo cada vez mais utilizada, e o crescente interesse por seus efeitos relaciona-se com a grande quantidade de publicações científicas. Muitos terapeutas e pesquisadores têm-se baseado na definição da dose do laser pela densidade energética (deltaE); porém, a grande variedade de equipamentos de laser pode levar a diferença nos resultados terapêuticos encontrados, por fornecerem parâmetros que variam de acordo com o fabricante. OBJETIVO: Analisar a energia final transmitida ao tecido ao aplicar-se a mesma deltaE em equipamentos de diferentes marcas nacionais. MATERIAIS E MÉTODOS: Foram avaliados sete equipamentos nacionais, com potência média (Pm) diferentes, e foram realizadas simulações aplicando deltaE de 1J/cm² em cada aparelho, para avaliar possíveis diferenças na energia final. RESULTADOS: A mesmadeltaE aplicada em diferentes aparelhos nacionais forneceu energia final que variou entre 10 e 90mJ. Esta variação na energia deveu-se principalmente a diferenças na Pm, sendo encontrados valores entre 5,4 e 75mW. CONCLUSÃO: Esta variabilidade na energia final, que é transmitida ao tecido, indica que a deltaE parece não ser o parâmetro que melhor descreve a dose a ser utilizada. É preciso mencionar não só a deltaE, mas também a energia final, para que se possa estabelecer a dose para obtenção do melhor resultado terapêutico.

INTRODUCTION: Low-level laser therapy is becoming more popular and there is a growing interest in its effects, as reflected in the increased number of articles published about the subject. Many therapists and researchers have used a laser dose definition based on energy density (deltaE). However, the variety of laser equipments may lead to differences in the therapeutic results found, since the parameters supplied by these equipments vary according to the manufacturer. OBJECTIVE: To analyze the final energy transmitted to the tissue when applying the same deltaE using equipment of different Brazilian brands. MATERIAL AND METHODS: Seven brands of Brazilian equipment with different mean power (Pm) were evaluated by means of simulations. deltaE of 1J/cm² was applied using each brand of equipment, in order to evaluate possible differences in the final energy. RESULTS: The same deltaE applied using different brands of Brazilian equipment supplied final energy that ranged from 10 to 90mJ. This variation in the energy was mainly due to differences in Pm. These values ranged between 5.4 and 75mW. CONCLUSIONS: This variability in the final energy that is transmitted to the tissue indicates that deltaE may not be the best parameter for describing the dose to be used. In addition to deltaE, the final energy needs also to be stated, in order to establish the dose for obtaining the best therapeutic results.

Effects of azelastine on allergen- and exercise-induced asthma.

The effects of the new anti-allergic drug, azelastine, on allergen- and exercise-induced asthma were studied. In six allergen inhalation tests for five asymptomatic asthmatic patients, the maximum percentage fall in FEV1.0 immediately after inhalation of allergen extract was 37.2 +/- 6.4 per cent (mean +/- SEM). As compared with a placebo, the maximum percentage fall in FEV1.0 with azelastine after inhalation of allergen extract in the same manner as with the placebo was 17.3 +/- 6.9 per cent. The difference was statistically significant (p less than 0.05). The percentage fall in FEV1.0 with placebo and azelastine in late asthmatic response (n = 4) was 36.0 +/- 5.3 per cent and 10.0 +/- 5.2 per cent, respectively. The difference was also statistically significant (p less than 0.01). An exercise test was carried out on seven asymptomatic asthmatic patients using an inclined treadmill. The maximum percentage fall in FEV1.0 without drugs, with diphenhydramine and azelastine was 38.9 +/- 5.0 per cent, 20.1 +/- 3.8 per cent and 11.3 +/- 3.1 per cent, respectively. Significant differences were found among each group (p less than 0.05). Azelastine was regarded as having sufficient potency to inhibit exercise-induced asthma; however, placebo effects cannot be ruled out with regard to the effects of diphenhydramine. These results suggests that chemical mediator release is involved not only in allergen-induced asthma but also in exercise-induced asthma, suggesting the clinical utility of azelastine.