Eficacia de la inyección local de acetato de metilprednisolona en el síndrome de pinzamiento subacromial. Un ensayo clínico aleatorizado, doble ciego / Efficacy of the local injection of methylprednisolone acetate in the subacromial impingement syndrome. A randomized, double-blind trial

Antecedentes: Las inyecciones locales de glucocorticoides son frecuentemente utilizadas en el tratamiento del síndrome de pinzamiento subacromial (SPSA); sin embargo, su eficacia es aún motivo de controversia. Objetivo: Comparar la eficacia de la inyección subacromial de metilprednisolona más lidocaína contra lidocaína sola en el tratamiento del SPSA. Material y método: Se incluyó a pacientes con SPSA definido por un resultado positivo en la prueba de la inyección de Neer, quienes fueron aleatorizados para recibir una inyección de 2 ml (40 mg/ml) de acetato de metilprednisolona más 1 ml de lidocaína al 1% (27 sujetos) o 3 ml de lidocaína al 1% (29 sujetos). Se comparó el cambio desde la línea basal en la calificación de una versión validada al español del Shoulder Disability Questionnaire (S-SDQ) de la intensidad del dolor y de los arcos de movilidad a los 15 y 30 días, y luego cada mes por 5 meses más. Resultados: El análisis mediante un modelo general lineal con ajuste para el tiempo de evolución y la intensidad del dolor en la línea basal no detectó diferencias en el cambio de la calificación S-SDQ y los arcos de movilidad entre los grupos de estudio en ningún momento del seguimiento. El grupo de lidocaína sola presentó mayor disminución en la intensidad del dolor durante todo el seguimiento. Conclusiones: La inyección subacromial de acetato de metilprednisolona no fue más eficaz que la inyección de lidocaína sola en pacientes con SPSA (AU)

Background: Local glucocorticosteroid injections are frequently used in the treatment of subacromial impingement syndrome (SIS), however its efficacy is still controversial. Objective: To compare the efficacy of the subacromial injection of methylprenisolone acetate plus lidocaine (MPL) versus lidocaine alone (LA) in SIS. Material and method: Consecutive SIS subjects, defined as a positive Neer’s injection test were randomized to a subacromial injection of 2 mL methylprednisolone acetate (40 mg/mL) plus 1 mL of 1% lidocaine (27 patients); or 3 mL of 1% lidocaine (29 patients) were studied. The change from baseline of the score of a Spanish validated version of the Shoulder Disability Questionnaire (S-SDQ), pain intensity, and shoulder range of motion were measured at 15 and 30 days, and afterward every month for five months. Results: After adjusting for duration of symptoms and pain intensity at baseline by way of a general lineal model, we did not find differences in the change of S-SDQ scores and shoulder range of motion between the study groups. Subjects randomized to LA had greater improvement of pain intensity than MPL subjects during the entire follow-up. Conclusions: A subacromial injection of methylprednisolone acetate was not more efficacious than the injection of lydocaine alone in patients with SIS (AU)

[Efficacy of the local injection of methylprednisolone acetate in the subacromial impingement syndrome. A randomized, double-blind trial]. / Eficacia de la inyección local de acetato de metilprednisolona en el síndrome de pinzamiento subacromial. Un ensayo clínico aleatorizado, doble ciego.

BACKGROUND: Local glucocorticosteroid injections are frequently used in the treatment of subacromial impingement syndrome (SIS), however its efficacy is still controversial. OBJECTIVE: To compare the efficacy of the subacromial injection of methylprenisolone acetate plus lidocaine (MPL) versus lidocaine alone (LA) in SIS. MATERIAL AND METHOD: Consecutive SIS subjects, defined as a positive Neer's injection test were randomized to a subacromial injection of 2 mL methylprednisolone acetate (40 mg/mL) plus 1 mL of 1% lidocaine (27 patients); or 3 mL of 1% lidocaine (29 patients) were studied. The change from baseline of the score of a Spanish validated version of the Shoulder Disability Questionnaire (S-SDQ), pain intensity, and shoulder range of motion were measured at 15 and 30 days, and afterward every month for five months. RESULTS: After adjusting for duration of symptoms and pain intensity at baseline by way of a general lineal model,we did not find differences in the change of S-SDQ scores and shoulder range of motion between the study groups. Subjects randomized to LA had greater improvement of pain intensity than MPL subjects during the entire follow-up. CONCLUSIONS: A subacromial injection of methylprednisolone acetate was not more efficacious than the injection of lydocaine alone in patients with SIS.

Development of a Spanish-language version of the Shoulder Disability Questionnaire.

BACKGROUND: The Shoulder Disability Questionnaire (SDQ) is a validated shoulder functional scale that has not yet been translated into Spanish. OBJECTIVE: The objective of this study was to develop and test the consistency of a Spanish translation of The Netherlands version of the SDQ (NSDQ). METHODS: A backtranslation process was used to generate a Spanish version of the NSDQ, called the S-SDQ. Subsequently, both the NSDQ and S-SDQ were administered to 30 bilingual (English/Spanish) subjects. Finally, the S-SDQ was administered to 35 monolingual Spanish-speaking subjects with shoulder pain on 2 occasions. External consistency between NSDQ and S-SDQ scores in the bilingual subjects, and between scores for the 2 S-SDQ applications in the monolingual subjects was assessed using the intraclass correlation coefficient (Ri). Internal consistency of the S-SDQ was assessed with Cronbach's alpha coefficient. RESULTS: In the bilingual subjects, the Ri between the NSDQ and S-SDQ scores was 0.991 (95% confidence interval [CI], 0.981-0.995). In the monolingual Spanish-speaking patients with shoulder pain, the Ri between the 2 S-SDQ scores was 0.99 (95% CI, 0.997-0.999). The Cronbach's alpha coefficient for the S-SDQ was 0.99. CONCLUSIONS: A highly consistent Spanish version of the NSDQ, the S-SDQ, was developed. This can be confidently used in clinical care and research settings for measurement of the functional status of shoulder joint disorders in Spanish-speaking subjects.

Hipersecreción gástrica en la pancreatoduodeneeectomía / Gastric hypersecretion in pancreatoduodenectomy

La pancreatoduodenectomía, conocida como operación de Whipple se realiza principalmente para el tratamiento de tumores malignos de la encrucijada biliopanjcreatoduodenal. Existe, en la actualidad, controversia en cuanto a las causas que condicionan sugieren un factor vagal importante en la génesis de las lesiones pépticas que acompañan a este procedimiento quirúrgico. En el presente trabajo se analizan los resultados obtenidos en dos grupos de perros tratados con operación de Whipple; uno sin y otro con vagotomía troncular añadida. Encontramos úlcera péptica marginal en el 78 y 14% de los casos y perforación en 44 y 0% de los mismos, respectivamente. Estos resultados y el análisis de otros hallazgos, sugieren la importancia de practicar vagotomía troncular añadida a la pancreatoduodenectomía, como medida preventiva en la producción de úlcera péptica marginal y sus complicaciones