Infiltración de esteroides, férula de muñeca y fonoforesis en el síndrome del túnel carpiano / Steroid injection, wrist splinting and phonophoresis in carpal tunnel syndrome

Introducción. A pesar de la variedad de tratamientos conservadores para el síndrome del túnel carpiano, no existe un claro consenso sobre su uso y efectividad. El objetivo de este estudio es comparar la efectividad a corto plazo de los tratamientos mediante infiltración de esteroides, férula de muñeca y fonoforesis. Pacientes y métodos. Ensayo clínico simple ciego, con asignación aleatoria estratificada con bloqueo. Se estudiaron 52 manos con mononeuropatía del nervio mediano por atrapamiento a nivel del carpo, de grado leve-moderado, distribuidas en tres grupos correspondientes a los tres tratamientos. La medida de resultado fue la variación de parámetros clínicos y de conducción nerviosa un mes después de concluir cada tratamiento. Las pruebas estadísticas utilizadas fueron el test de correlación de Spearman, el ANOVA y la prueba de Bonferroni. El nivel de significación fue p < 0,05. Resultados. Los parámetros clínicos no mostraron diferencias entre los tres tratamientos. Se encontró una mejoría significativa de las conducciones nerviosas en el grupo de infiltración de esteroides en comparación con el de fonoforesis, pero no en el resto del análisis. En el grupo tratado con férula hubo una discreta mejoría de un parámetro de conducción nerviosa respecto al estudio basal. La fonoforesis no tuvo ningún efecto sobre las conducciones. Conclusiones. Los estudios de conducción nerviosa fueron una buena herramienta para valorar los resultados del tratamiento. La infiltración con esteroides obtuvo los mejores resultados, la férula de muñeca sólo lo hizo de forma aislada y la fonoforesis no tuvo efectos detectables

Introduction. There is some variety of conservative therapies for the carpal tunnel syndrome, but not a clear consensus about their use and effectiveness. The objective of this study is to compare the effectiveness of three of them: steroid injection, wrist splinting and phonophoresis. Patients and method. Single-blind, randomised clinical trial with blocking and stratification. We studied 52 hands with median nerve entrapment at the wrist, mild and moderate in severity, distributed in three groups corresponding to the three therapies compared. The outcome measure was the variation of clinical parameters and nerve conduction studies one month after each treatment ended. The statistical analysis included Spearman's correlation test, ANOVA and Bonferroni test. Significance level was set at p < 0.05. Results. The outcome of clinical parameters could not differentiate one treatment from another. Nerve conduction studies improved significantly in the steroid injection group when compared to the phonophoresis group, but not in the rest of the analysis. One nerve conduction parameter showed a minor significant improvement when compared to the basal study in the wrist splinting group. Phonophoresis had no effect on nerve conduction studies. Discussion. Nerve conduction studies were a good tool to evaluate treatment outcome in this study design. Steroid injection improved them more than phonophoresis, a treatment that had no detectable effects, whereas wrist splitting only produced minor improvement

Factores clínicos de riesgo de la vitreorretinopatía proliferativa después de la cirugía del desprendimiento de retina / Clinical risk factors for proliferative vitreoretinopathy after retinal detachment surgery

Objetivo: Identificar los factores clínicos de riesgo del desarrollo de vitreorretinopatía proliferativa (PVR) severa tras la cirugía escleral del desprendimiento de retina (DR).Métodos: Se realizó un estudio retrospectivo de 124 pacientes con DR tratados inicialmente con procedimientos esclerales convencionales sin PVR o con PVR de grado menor al C.1 en el examen inicial. Después de la cirugía la PVR severa se definió como grado C.2 o peor. Se evaluaron los datos relativos a las 34 series estadísticas (96 variables) mediante un análisis univariable y una regresión logística múltiple. Resultados: Se comprobó el desarrollo de una PVR severa tras la cirugía en 13 pacientes (10,48 por ciento). Se identificaron siete variables predictivas significativas: grado A de PVR preoperatoria (p=0,005), desprendimiento que afecta a más de 2 cuadrantes (p=0,019), tracción vítrea preoperatoria (p=0,012), inyecciones perforantes (p=0,046), perforaciones esclerales (p=0,001), desgarros no sellados (p=0,001), y tracción vítrea postoperatoria (p=0,002).Conclusiones: Los resultados indican que además de la extensión del desprendimiento, y presencia de inflamación preoperatoria o bajo grado de PVR, los problemas y atrogénicos son también factores importantes en la patogénesis de PVR severa tras la cirugía del DR (AU)

[Clinical risk factors for proliferative vitreoretinopathy after retinal detachment surgery]. / Factores clínicos de riesgo de la vitreorretinopatía proliferativa después de la cirugía del desprendimiento de retina.

PURPOSE: To identify the clinical risk factors for the development of severe proliferative vitreoretinopathy (PVR) after scleral buckling procedures for retinal detachment (RD). METHODS: A retrospective study of 124 patients with rhegmatogeneus RD treated initially with buckling procedures, with either no PVR or with no PVR of grade C-l or less at initial examination was conducted. After surgery, severe PVR was defined as grade C-2 or worse. Univariate analysis and stepwise logistic regression evaluated the data relating to 34 statistical series (96 variables). RESULTS: Severe PVR develop after surgery in 13 patients (10.48%). Seven significant predictive variables were identified: grade A preoperative PVR (p=0.005), detachment involving more than 2 quadrants (p=0.019), preoperative vitreous traction (p=0.002), intravitreal injection (p=0.046), scleral perforation (p=0.001), unsealed break (p=0.001), and postoperative vitreous traction (p=0.012). CONCLUSIONS: The results indicate that in addition to the extent of detachment, and presence of preoperative inflammation or low grade PVR, iatrogenic problems also are important factors in the pathogenesis of severe PVR after surgery for RD.

TBA test by an extractive method applied to 'paté'.

The aim of this work was to study the influence of different conditions on the thiobarbituric acid (TBA) test, determined by the extractive method, as a measure of lipid oxidation in 'paté'. Different extracting agents (trichloroacetic acid and trichloroacetic acid in 2 M phosphoric acid), different concentrations of these acids (10, 15 and 20%), different reaction times and temperatures (35 min at 100 °C and 900 min at room temperature) and the effect of sulfanilamide additions were evaluated. All the samples were measured by HP 8451A Diode ARRAY spectrophotometer at 532 nm. Significant differences between 35 and 900 min of MA-TBA reaction time were found. Highest TBA numbers were found in samples with a reaction time of 35 min in a thermostatically controlled waterbath at 100 °C, rather than 900 min at room temperature. Lowest TBA numbers were found in samples with the addition of sulfanilamide rather than without it. The 10% TCA solution gave the best recovery percentages for 'paté', making it the preferred extractant.

Modification of physico-chemical and colour parameters during the marketing of 'paté'.

The evolution of different physico-chemical parameters (iodine number, TBA test, residual nitrite level, pH and moisture) and CIE L (∗)a (∗)b (∗) colour evolution, in pork liver 'pate', with and without sodium ascorbate addition, were studied. The samples were stored in an illuminated display cabinet at different lux intensities and in the dark. The regression equations were obtained for each one of the parameters under study, from the first day of exposure to light. The sodium ascorbate showed a protective effect on the photo-oxidation mechanism (measured by TBA test), but it did not have an influence on the samples in darkness. In both types of paté exposed to light, fading takes place and the most important variations in colour parameters are produced during the first 24 h of exposure to light.