Efectividad de la electrólisis percutánea intratisular (EPI®) en las tendinopatías crónicas del tendón rotuliano / Effectiveness of electrolysis percutaneous intratisular (EPI®) in chronic insertional patellar tendinopathy

Objetivo: El objetivo del estudio es evaluar la efectividad de la electrólisis percutánea intratisular (EPI®) en la tendinopatía rotuliana crónica. Material y método: Estudio observacional en 32 pacientes (59,4% hombres), con una media de edad de 35 años (DE: 8) diagnosticados de tendinopatía rotuliana con más de 6 meses de evolución desde el inicio de los síntomas. Se evaluó la estructura del tendón a través de ecografía y la función con la escala VISA-P. Los sujetos fueron incluidos en el grupo 1 (VISA<50 puntos) y en el grupo 2 (VISA>50 puntos). Se aplicó la EPI® de forma aislada en cada sesión asociada con carácter domiciliario a trabajo excéntrico y estiramientos. En la evaluación inicial, todos presentaban cambios compatibles con un proceso degenerativo, el 50% presentaban hipervascularización (100% con VISA<50). Trece pacientes obtuvieron una puntuación VISA<50 y 19 VISA>50. Resultados: En el Grupo 1, el 80% de los pacientes alcanzaron el alta en fisioterapia a las 6 semanas desde el inicio de tratamiento con EPI®, con una media de 6 sesiones de EPI®. En el Grupo 2 (VISA>50) todos lograron el alta tras 4 sesiones de EPI®. Conclusiones: La EPI® constituye un tratamiento efectivo para la tendinopatía rotuliana crónica (AU)

Objective: This study aimed to evaluate the effectiveness of the electrolysis percutaneous intratisular (EPI®) in chronic patellar tendinopathy. Material and method: Observational study in 32 subjects, 59.4% men, with a mean age of 35 years (SD: 8) with diagnosis of patellar tendinopathy with more than six months of evolution from the onset of symptoms. We evaluated the structure of the tendon through musculoskeletal ultrasound and function through the VISAP scale. The subjects were classified into: Group 1 (VISA <50 points) and Group 2 (VISA> 50 points). EPI® was applied in isolation in each session associated with eccentric character home to work and stretching. On the first assessment, all the patients had changes consistent with a degenerative process, 50% showed hypervascularity (100% VISA <50). Thirty patients achieved a VISA score <50 and 19 VISA> 50. Results: In Group 1 (VISA <50), 80% of subjects achieved a cure at 6 weeks after beginning treatment with EPI®, with an average of 6 sessions of EPI®. In Group 2 (VISA> 50) all the subjects achieved a cure after four sessions of EPI®. Conclusions: The EPI ® is an effective treatment for chronic patellar tendinopathy (AU)

A review of low-level tritium systems and sensitivity requirements.

Data from three international intercomparison projects are used to study the state of the tritium low-level technique and to set a realistic sensitivity level that should be demanded in ultralow-level tritium work, mainly in hydrology and oceanography. Only two laboratories reach the required goal, a standard deviation < or = 0.03 TU for weak samples. The methods used are described and important parameters illustrated graphically. Possible improvements in the measuring techniques are discussed, including the design of better counting systems.

Estimated prevalence of undiagnosed glucose intolerance from hyperandrogenic anovulation among women requesting electrolysis.

OBJECTIVE: Hyperandrogenic anovulation is the principal risk factor for non-insulin-dependent diabetes mellitus (NIDDM) in young women. Since many of these women undergo depilatory therapy, the purpose of this study was to estimate the probability of undiagnosed glucose intolerance associated with hyperandrogenic anovulation among premenopausal women requesting electrolysis. DESIGN: Case-series study. INTERVENTIONS: Women (N = 791) attending one of 27 electrology clinics in the United States, Canada and Germany received questionnaires requesting anthropometric data; personal information regarding age, surgery and medication use, and family histories of excess hair growth in female relatives and diabetes in parents or siblings. RESULTS: Of 652 respondents less than age 50 years, 643 (98.6%) women had hirsutism, of whom 465 had regular menstrual cycles. One hundred seventy-eight (27.3%) women less than 50 years of age had hirsutism with irregular menses, and one-half of these women also were obese. Regardless of adiposity, one-third of hirsute women with menstrual irregularity knew the cause of their androgen excess, while the remaining two-thirds were unaware of the reason for their excess hair growth. CONCLUSIONS: Assuming a 20% risk of glucose intolerance in obese hyperandrogenic anovulatory women by the fourth decade of life, the estimated prevalence of undiagnosed glucose intolerance from hyperandrogenic anovulation is 1.7% among women requesting electrolysis before age 50 years.

Prevalence of nonclassical congenital adrenal hyperplasia among women self-referred for electrolytic treatment of hirsutism.

Nonclassical congenital adrenal hyperplasia (NCCAH) is well recognized among women who seek medical attention for hirsutism. However, the prevalence of this disorder among women self-referred for electrolytic treatment of hirsutism is unknown. We hypothesized that the prevalence of NCCAH among women attending an electrolysis clinic might be high. By measuring the morning salivary 17-hydroxyprogesterone (17-OHP) as a screening test for NCCAH in 46 women in the follicular phase of their menstrual cycle, we identified 12 subjects with a high basal salivary 17-OHP. Eleven agreed to have a 60-minute Cosyntropin-stimulation test, as did an additional 6 of 9 women with normal basal salivary 17-OHP, but with a particularly high hirsutism score. One of the women with high basal salivary 17-OHP had a 60-minute Cosyntropin response, which was diagnostic of NCCAH. She was of the Ashkenazi Jewish decent, a group previously reported to have a high prevalence of NCCAH. A second woman with high salivary 17-OPH had a Cosyntropin-stimulation response consistent with heterozygosity for 21-hydroxylase deficiency. None of the Cosyntropin-stimulation responses in those chosen for a high hirsutism score were diagnostic. Thus, 1 of 46 (2.2%) of the women who entered our study had unrecognized NCCAH, a prevalence only about 2-fold greater than that reported in the general population. Therefore, we recommend that electrolysis clinics advise clients from ethnic groups known to have a high frequency of NCCAH of the advisability of having a formal medical evaluation for NCCAH.