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[PMID]:28463817
[Au] Autor:Zheng C; Zhu Y; Zhu D; Lu F; Xia X; Jiang J; Ma X
[Ad] Endereço:Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai 200040, China.
[Ti] Título:Motor unit number estimation in the quantitative assessment of severity and progression of motor unit loss in Hirayama disease.
[So] Source:Clin Neurophysiol;128(6):1008-1014, 2017 06.
[Is] ISSN:1872-8952
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To investigate motor unit number estimation (MUNE) as a method to quantitatively evaluate severity and progression of motor unit loss in Hirayama disease (HD). METHODS: Multipoint incremental MUNE was performed bilaterally on both abductor digiti minimi and abductor pollicis brevis muscles in 46 patients with HD and 32 controls, along with handgrip strength examination. MUNE was re-evaluated approximately 1year after initial examination in 17 patients with HD. RESULTS: The MUNE values were significantly lower in all the tested muscles in the HD group (P<0.05). Despite abnormally low MUNE values, 54.3% (25/46) of patients with HD had normal ipsilateral grip power. There was a significant inverse correlation between MUNE values and disease duration (P<0.05). A longitudinal follow-up MUNE analysis demonstrated slow progression of motor unit loss in patients with HD within approximately 1year (P<0.05), even in patients with an illness duration >4years. CONCLUSIONS: A reduction in the functioning motor units was found in patients with HD compared with that in controls, even in the early asymptomatic stages. Moreover, the motor unit loss in HD progresses gradually as the disease advances. SIGNIFICANCE: These results have provided evidence for the application of MUNE in estimating the reduction of motor unit in HD and confirming the validity of MUNE for tracking the progression of HD in a clinical setting.
[Mh] Termos MeSH primário: Força da Mão
Nervo Mediano/fisiopatologia
Músculo Esquelético/fisiopatologia
Atrofias Musculares Espinais da Infância/fisiopatologia
Nervo Ulnar/fisiopatologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Estudos de Casos e Controles
Progressão da Doença
Eletromiografia/métodos
Seres Humanos
Músculo Esquelético/inervação
Atrofias Musculares Espinais da Infância/diagnóstico
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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[PMID]:28778254
[Au] Autor:Wu YT; Ho TY; Chou YC; Ke MJ; Li TY; Tsai CK; Chen LC
[Ad] Endereço:Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, Taipei, Taiwan, Republic of China; Integrated Pain Management Center, Tri-Service General Hospital, School of Medicine, Taipei, Taiwan, Republic of China.
[Ti] Título:Six-month Efficacy of Perineural Dextrose for Carpal Tunnel Syndrome: A Prospective, Randomized, Double-Blind, Controlled Trial.
[So] Source:Mayo Clin Proc;92(8):1179-1189, 2017 Aug.
[Is] ISSN:1942-5546
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess the 6-month effectiveness of ultrasound-guided perineural injection therapy (PIT) using 5% dextrose (D5W) in patients with mild-to-moderate carpal tunnel syndrome (CTS). PATIENTS AND METHODS: A prospective, randomized, placebo-controlled, and double-blind study was conducted between May 1, 2016, through March 30, 2017. A total of 49 participants diagnosed with mild-to-moderate CTS were randomized into D5W and control groups. Participants in the D5W group received 1 session of ultrasound-guided PIT with 5 cc of D5W, and the control group received PIT with normal saline. The visual analog scale measured pain as a primary outcome. Secondary outcomes were Boston Carpal Tunnel Syndrome Questionnaire scores, the cross-sectional area of the median nerve, and electrophysiological measurement results. Assessment was performed before injection and at 1, 3, and 6 months post-injection. RESULTS: All patients (data from 30 wrists in each group) completed the study. Compared with the control group, at all post-injection time points, the D5W group had a significant reduction in pain and disability, improvement on electrophysiological response measures, and decreased cross-sectional area of the median nerve. CONCLUSION: Our study reveals that ultrasound-guided PIT with D5W is an effective treatment for patients with mild-to-moderate CTS. TRIAL REGISTRATION: www.ClinicalTrials.gov: NCT02809261.
[Mh] Termos MeSH primário: Síndrome do Túnel Carpal/tratamento farmacológico
Método Duplo-Cego
Glucose/administração & dosagem
Medição da Dor/estatística & dados numéricos
[Mh] Termos MeSH secundário: Seres Humanos
Nervo Mediano/diagnóstico por imagem
Ultrassonografia de Intervenção/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
IY9XDZ35W2 (Glucose)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170822
[Lr] Data última revisão:
170822
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170806
[St] Status:MEDLINE


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[PMID]:28723767
[Au] Autor:Krähenbühl SM; Cvancara P; Stieglitz T; Bonvin R; Michetti M; Flahaut M; Durand S; Deghayli L; Applegate LA; Raffoul W
[Ad] Endereço:aPlastic, Reconstructive and Hand Surgery Division, CHUV - Lausanne University Hospital, Lausanne, Switzerland bLaboratory for Biomedical Microtechnology, University of Freiburg, Freiburg im Breisgau, Germany cEducation Unit, CHUV - Lausanne University Hospital, Lausanne, Switzerland.
[Ti] Título:Return of the cadaver: Key role of anatomic dissection for plastic surgery resident training.
[So] Source:Medicine (Baltimore);96(29):e7528, 2017 Jul.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Successful Plastic Surgery Residency training is subjected to evolving society pressure of lower hourly work weeks imposed by external committees, labor laws, and increased public awareness of patient care quality. Although innovative measures for simulation training of surgery are appearing, there is also the realization that basic anatomy training should be re-enforced and cadaver dissection is of utmost importance for surgical techniques.In the development of new technology for implantable neurostimulatory electrodes for the management of phantom limb pain in amputee patients, a design of a cadaveric model has been developed with detailed steps for innovative transfascicular insertion of electrodes. Overall design for electrode and cable implantation transcutaneous was established and an operating protocol devised.Microsurgery of the nerves of the upper extremities for interfascicular electrode implantation is described for the first time. Design of electrode implantation in cadaver specimens was adapted with a trocar delivery of cables and electrodes transcutaneous and stabilization of the electrode by suturing along the nerve. In addition, the overall operating arena environment with specific positions of the multidisciplinary team necessary for implantable electrodes was elaborated to assure optimal operating conditions and procedures during the organization of a first-in-man implantation study.Overall importance of plastic surgery training for new and highly technical procedures is of importance and particularly there is a real need to continue actual cadaveric training due to patient variability for nerve anatomic structures.
[Mh] Termos MeSH primário: Cadáver
Dissecação/educação
Educação de Pós-Graduação em Medicina/métodos
Internato e Residência
Cirurgia Plástica/educação
[Mh] Termos MeSH secundário: Amputação
Braço/cirurgia
Protocolos Clínicos
Eletrodos Implantados
Desenho de Equipamento
Seres Humanos
Nervo Mediano/cirurgia
Microcirurgia/educação
Modelos Anatômicos
Procedimentos Neurocirúrgicos/educação
Equipe de Assistência ao Paciente
Membro Fantasma/etiologia
Membro Fantasma/cirurgia
Nervo Ulnar/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170801
[Lr] Data última revisão:
170801
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007528


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[PMID]:28719556
[Au] Autor:Leslie BM; Osterman AL; Wolfe SW
[Ad] Endereço:1Newton-Wellesley Hospital, Newton, Massachusetts 2The Philadelphia Hand Center, King of Prussia, Pennsylvania 3Center for Brachial Plexus and Traumatic Nerve Injury, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY.
[Ti] Título:Inadvertent Harvest of the Median Nerve Instead of the Palmaris Longus Tendon.
[So] Source:J Bone Joint Surg Am;99(14):1173-1182, 2017 Jul 19.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The palmaris longus tendon is frequently used as a tendon graft or ligament replacement. In rare instances the median nerve has been inadvertently harvested instead of the palmaris longus for use as a tendon. METHODS: Nineteen cases in which the median nerve had been mistakenly harvested instead of the palmaris longus tendon were collected from members of the American Society for Surgery of the Hand (ASSH) Listserve. Surgeons involved in the subsequent care of the subject who had had an inadvertent harvest were contacted or the chart was reviewed. The reason for the initial procedure, the skill level of the primary surgeon, and when the inadvertent harvest was recognized were documented. When possible, the method of harvest and subsequent treatment were also documented. RESULTS: The most common initial procedure was a reconstruction of the elbow ulnar collateral ligament, followed by basal joint arthroplasty, tendon reconstruction, and reconstruction of the ulnar collateral ligament of the thumb metacarpophalangeal joint. Only 7 of the inadvertent harvests were recognized intraoperatively; in the remaining 12 cases the nerve was used as a tendon graft. The sensory loss was not recognized as being due to the inadvertent harvest until the first postoperative visit (2 subjects), 3 to 4 weeks (2 subjects), 2 to 3 months (2 subjects), 5 to 7 months (2 subjects), 1 year (1 subject), 3 years (1 subject), or 10 years (1 subject). Preoperative clinical identification of the presence or absence of a palmaris longus did not necessarily prevent an inadvertent harvest. CONCLUSIONS: Knowledge of the relevant anatomy is crucial to avoiding inadvertent harvest of the median nerve instead of the palmaris longus tendon.
[Mh] Termos MeSH primário: Nervo Mediano/cirurgia
Erros Médicos
Transferência Tendinosa/efeitos adversos
Tendões/transplante
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Criança
Feminino
Hospitais de Ensino/estatística & dados numéricos
Seres Humanos
Ligamentos Laterais do Tornozelo/cirurgia
Masculino
Coleta de Tecidos e Órgãos/efeitos adversos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170719
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.16.01218


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[PMID]:28658435
[Au] Autor:Chen L; Chen J; Hu B; Jiang LX
[Ad] Endereço:Department of Ultrasound in Medicine, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China.
[Ti] Título:Sonographic Findings of the Bifid Median Nerve and Persistent Median Artery in Carpal Tunnel: A Preliminary Study in Chinese Individuals.
[So] Source:Clinics (Sao Paulo);72(6):358-362, 2017 Jun.
[Is] ISSN:1980-5322
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE:: The aim of this study was to investigate the prevalence of anatomic variations of the bifid median nerve, persistent median artery and persistent median vein in Chinese individuals and their relationship with carpal tunnel syndrome. METHODS:: One hundred and sixty median nerves were examined using ultrasonography and colour Doppler ultrasonography. The location, shape, and size of the bifid median nerve, persistent median artery and persistent median vein were recorded. The cross-sectional area of the bifid median nerve (two trunks) was measured at the level of the pisiform. RESULTS:: Among the 160 wrists examined, a bifid median nerve was observed in 15 (9.4%) wrists, and a persistent median artery was observed in 12 (7.5%) wrists. These two variations either coexisted or were observed independently, and the probability of coexistence (6.3%) was higher than the probability of existing independently (bifid median nerve only 3.1%, persistent median artery only 1.3%). The cross-sectional area of the radial trunk was greater than (13 in 15, 86.7%) the cross-sectional area of the ulnaris trunk. Persistent median vein was observed in 9 wrists (5.6%). CONCLUSIONS:: The persistent median artery and bifid median nerve tend to coexist, and the persistent median vein sometimes runs parallel to the persistent median artery. Their positional relationship in carpal tunnel is uncertain, and thus, preoperative ultrasound is necessary. These three variations do not present any additional risk for the development of carpal tunnel syndrome.
[Mh] Termos MeSH primário: Artérias/diagnóstico por imagem
Síndrome do Túnel Carpal/diagnóstico por imagem
Nervo Mediano/diagnóstico por imagem
[Mh] Termos MeSH secundário: Artérias/anormalidades
Síndrome do Túnel Carpal/etiologia
Feminino
Seres Humanos
Masculino
Nervo Mediano/anormalidades
Ultrassonografia Doppler em Cores
Punho/irrigação sanguínea
Punho/diagnóstico por imagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171005
[Lr] Data última revisão:
171005
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170629
[St] Status:MEDLINE


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[PMID]:28640120
[Au] Autor:Özdemir G
[Ad] Endereço:Atatürk University Medical Faculty, Department of Neurology, Erzurum City, Turkey.
[Ti] Título:Working hand syndrome: A new definition of non-classified polyneuropathy condition.
[So] Source:Medicine (Baltimore);96(25):e7235, 2017 Jun.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this paper was to define an unexplained non-classified polyneuropathy condition as a new neurological disease. This new diagnosis of occupation related polyneuropathy has been named as "WORKING HAND SYNDROME (WHS)."This study collected and compared clinic and electrophysiological analyze data from healthy controls, WHS patients, carpal tunnel syndrome (CTS) patients and polyneuropathy patients. The WHS patients presented to the clinic with pain, numbness, tingling, and burning sensations in their hands that increased significantly during rest and nighttime. However, there was no weakness in the muscles, and the deep tendon reflexes were normal in this disease. The patients had all been working in physically demanding jobs requiring the use of their hands/arms for at least 1 year, but no vibrating tools were used by the patients. All of the cases were men. I supposed that overload caused by an action repeated chronically by the hand/arm may impair the sensory nerves in mentioned hand/arm. In patients with these complaints, for a definitive diagnosis, similar diseases must be excluded. Nonetheless, the specific electrophysiological finding that the sural nerves are normal on the lower sides, as well as the occurrence of sensory axonal polyneuropathy in the sensory nerves without a significant effect on velocity and latency in the work-ups of the upper extremity are enough to make a diagnosis.In conclusion, WHS has been defined as a polyneuropathy and occupational disease. Patients with WHS present with pain, numbness, tingling, and burning sensations in their hands that increases significantly during rest and nighttime. They also use their arms/hands for jobs that require heavy labor. The neurological examinations of patients with WHS are normal. Only the sensory nerves in the upper extremities are affected. This article is suggested to serve as a resource for patients, health care professionals, and members of the neurology community at large.
[Mh] Termos MeSH primário: Transtornos Traumáticos Cumulativos/classificação
Mãos
Doenças Profissionais/classificação
Doenças do Sistema Nervoso Periférico/classificação
Polineuropatias/classificação
[Mh] Termos MeSH secundário: Síndrome do Túnel Carpal/diagnóstico
Síndrome do Túnel Carpal/fisiopatologia
Transtornos Traumáticos Cumulativos/diagnóstico
Transtornos Traumáticos Cumulativos/fisiopatologia
Diagnóstico Diferencial
Eletromiografia
Mãos/fisiopatologia
Seres Humanos
Masculino
Nervo Mediano/fisiopatologia
Meia-Idade
Condução Nervosa
Doenças Profissionais/diagnóstico
Doenças Profissionais/fisiopatologia
Doenças do Sistema Nervoso Periférico/diagnóstico
Doenças do Sistema Nervoso Periférico/fisiopatologia
Polineuropatias/diagnóstico
Polineuropatias/fisiopatologia
Reflexo
Nervo Sural/fisiopatologia
Síndrome
Terminologia como Assunto
Nervo Ulnar/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170717
[Lr] Data última revisão:
170717
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170623
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007235


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[PMID]:28635099
[Au] Autor:Woo EHC; White P; Lai CWK
[Ad] Endereço:Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Room Y934, 9/F, Lee Shau Kee Building, Hung Hom, Kowloon, Hong Kong Special Administrative Region, China.
[Ti] Título:Effects of electronic device overuse by university students in relation to clinical status and anatomical variations of the median nerve and transverse carpal ligament.
[So] Source:Muscle Nerve;56(5):873-880, 2017 Nov.
[Is] ISSN:1097-4598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: This study investigates the results of a questionnaire, provocative tests, and ultrasonographic measurements of carpal tunnel morphological parameters in intensive and nonintensive electronic device users. METHODS: Forty-eight university students (equal numbers of intensive and nonintensive users, ≥5 h/day and <5 h/day of electronic device usage, respectively) were randomly selected after questionnaire responses were received and evaluated clinically and by ultrasonography. All participants were right-handed. RESULTS: Intensive users had significantly more positive results in Phalen's and Durkan's tests and reported more wrist/hand pain compared with nonintensive users (P < 0.05). Intensive users also had significantly larger median nerve cross-sectional areas, flattening ratios, and perimeters as well as greater bowing of the transverse carpal ligament compared with nonintensive users (P < 0.05). DISCUSSION: Overuse of electronic devices may adversely affect the median nerve within the carpal tunnel and the transverse carpal ligament, resulting in numbness, tingling, and pain in the hand. Caution may be warranted when using handheld electronic devices. Muscle Nerve 56: 873-880, 2017.
[Mh] Termos MeSH primário: Síndrome do Túnel Carpal/etiologia
Síndrome do Túnel Carpal/patologia
Nervo Mediano/diagnóstico por imagem
Nervo Mediano/fisiopatologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Síndrome do Túnel Carpal/diagnóstico por imagem
Feminino
Seres Humanos
Masculino
Exame Físico
Reprodutibilidade dos Testes
Estudantes
Inquéritos e Questionários
Ultrassonografia
Universidades
Punho/inervação
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171019
[Lr] Data última revisão:
171019
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170622
[St] Status:MEDLINE
[do] DOI:10.1002/mus.25697


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[PMID]:28628532
[Au] Autor:Burnham R; Playfair L; Loh E; Roberts S; Agur A
[Ad] Endereço:From the Central Alberta Pain and Rehabilitation Institute, Lacombe (RB, LP); Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton (RB), Alberta; Department of Physical Medicine and Rehabilitation, Parkwood Institute, Western University, London (EL); and Division of Anatomy, Department of Surgery (SR, AA), and Division of Physical Medicine and Rehabilitation (AA), University of Toronto, Toronto, Ontario, Canada.
[Ti] Título:Evaluation of the Effectiveness and Safety of Ultrasound-Guided Percutaneous Carpal Tunnel Release: A Cadaveric Study.
[So] Source:Am J Phys Med Rehabil;96(7):457-463, 2017 Jul.
[Is] ISSN:1537-7385
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The looped thread carpal tunnel release (TCTR) procedure is a minimally invasive percutaneous technique performed under ultrasound (US) to transect the transverse carpal ligament in patients with carpal tunnel syndrome. Study objectives were to evaluate the accuracy of identifying key US landmarks, safety, effectiveness, and technical difficulty of TCTR. DESIGN: Fourteen lightly embalmed cadaveric distal forearm-hand specimens were subject to US identification of key landmarks, TCTR procedure, and post-TCTR dissection. Outcome measures of interest were (1) correspondence between key landmarks (median nerve and 4 bony pillars of transverse carpal ligament) identified on US and anatomical structures exposed by dissection, (2) percentage of the transverse carpal ligament transected and location of the transection, (3) frequency of damage to adjacent structures, (4) time to complete procedure, and (5) operator assessment of technical difficulty of each TCTR procedure (0 = extremely easy, 10 = extremely difficult). RESULTS: (1) Skin markings delineating the position of US-visualized landmarks corresponded almost perfectly to anatomical dissection. (2) Nine (64.2%) of 14 specimens had complete division of the transverse carpal ligament. In the remaining 5 specimens, an average of 68.8% of the ligament was transected. (3) No adjacent structures were damaged. (4) Time to complete the procedure was on average 9.9 ± 4.6 minutes. (5) Average procedural difficulty was 4.3/10. CONCLUSIONS: Thread carpal tunnel release is potentially a safe, quick, and effective procedure to transect the transverse carpal ligament. Future clinical investigation is recommended.
[Mh] Termos MeSH primário: Pontos de Referência Anatômicos/cirurgia
Síndrome do Túnel Carpal/cirurgia
Dissecação/métodos
Ultrassonografia de Intervenção/métodos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Cadáver
Ossos do Carpo/anatomia & histologia
Ossos do Carpo/cirurgia
Feminino
Seres Humanos
Ligamentos Articulares/anatomia & histologia
Ligamentos Articulares/cirurgia
Masculino
Nervo Mediano/anatomia & histologia
Nervo Mediano/cirurgia
Articulação do Punho/anatomia & histologia
Articulação do Punho/cirurgia
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170823
[Lr] Data última revisão:
170823
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170620
[St] Status:MEDLINE
[do] DOI:10.1097/PHM.0000000000000652


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[PMID]:28538376
[Au] Autor:Chen J; Chen L; Wu L; Wang R; Liu JB; Hu B; Jiang LX
[Ad] Endereço:aDepartment of Ultrasound in Medicine, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, People's Republic of China bDepartment of Radiology, Thomas Jefferson University, Philadelphia, PA, USA.
[Ti] Título:Value of superb microvascular imaging ultrasonography in the diagnosis of carpal tunnel syndrome: Compared with color Doppler and power Doppler.
[So] Source:Medicine (Baltimore);96(21):e6862, 2017 May.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to compare the value of superb microvascular imaging (SMI) in carpal tunnel syndrome (CTS) with that of color Doppler ultrasonography (CDUS) and power Doppler ultrasonography (PDUS).Fifty patients with symptomatic CTS and 25 healthy volunteers were enrolled. The cross-sectional area (CSA), CDUS score, PDUS score, and SMI score of the median nerve (MN) at the carpal tunnel were recorded. The value of different ultrasonography (US) diagnostic strategies was calculated.The blood flow display ratio in the MN of the healthy volunteers had no statistical difference between CDUS, PDUS, and SMI (20%, 32%, and 48%, respectively, P >.05). The blood flow display ratio for SMI in patients was significantly higher than that of CDUS and PDUS (90%, 52%, and 60%, respectively, P <.005). The accuracy of SMI score ≥2 (79%) was much higher than that of CDUS and PDUS (61% and 63%, respectively, P <.05). Comprehensive consideration of SMI and CSA, CSA≥10.5 mm, and/or SMI score ≥2 has the highest accuracy (83%), significantly higher than that of CSA combination with CDUS or PDUS (68% and 69%, respectively, P <.05).SMI is more sensitive to display the blood flow in the MN with CTS than CDUS and PDUS. It might significantly improve the diagnosis value for CTS.
[Mh] Termos MeSH primário: Síndrome do Túnel Carpal/diagnóstico por imagem
Hemodinâmica
Nervo Mediano/irrigação sanguínea
Nervo Mediano/diagnóstico por imagem
Microvasos/diagnóstico por imagem
Ultrassonografia
[Mh] Termos MeSH secundário: Algoritmos
Síndrome do Túnel Carpal/fisiopatologia
Feminino
Seres Humanos
Masculino
Microvasos/fisiopatologia
Meia-Idade
Variações Dependentes do Observador
Tamanho do Órgão
Estudos Prospectivos
Curva ROC
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170626
[Lr] Data última revisão:
170626
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170525
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000006862


  10 / 8566 MEDLINE  
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[PMID]:28501137
[Au] Autor:Namazi H; HajiVandi S
[Ad] Endereço:Bone and Joint Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address: namazih@sums.ac.ir.
[Ti] Título:Supinator to ulnar nerve transfer via in situ anterior interosseous nerve bridge to restore intrinsic muscle function in combined proximal median and ulnar nerve injury: a novel cadaveric study.
[So] Source:J Surg Res;211:95-99, 2017 May 01.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In cases of high ulnar nerve palsy, result of nerve repair in term of intrinsic muscle recovery is unsatisfactory. Distal nerve transfer can diminish the regeneration time and improve the results. But, there was no perfect distal nerve transfer for restoring intrinsic hand function in combined proximal median and ulnar nerve injuries. This cadaveric study aims to evaluate the possibility and feasibility of supinator nerve transfer to motor branch of ulnar nerve (MUN). METHODS: Ten cadaveric upper limbs dissected to identify the location of the supinator branch, anterior interosseous nerve (AIN), and MUN. The AIN was cut from its origin and transferred to the supinator branches. Also, the AIN was distally cut and transferred to the MUN. After nerve coaptation, surface area, fascicle count, and axon number were determined by histologic methods. RESULTS: In all limbs, the proximal and distal stumps of AIN reached the supinator branch and the MUN without tension, respectively. The mean of axon number in the supinator, proximal stump of AIN, distal stump of AIN and MUN branches were 32,426, 45,542, 25,288, and 35,426, respectively. CONCLUSIONS: This study showed that transfer of the supinator branches to the MUN is possible via the in situ AIN bridge. The axon count data showed a favorable match between the supinator branches, AIN, and MUN. Therefore, it is suggested that this technique can be useful for patients with combined high median and ulnar nerve injuries.
[Mh] Termos MeSH primário: Nervo Mediano/lesões
Músculo Esquelético/inervação
Transferência de Nervo/métodos
Traumatismos dos Nervos Periféricos/cirurgia
Nervo Ulnar/lesões
[Mh] Termos MeSH secundário: Estudos de Viabilidade
Seres Humanos
Nervo Mediano/cirurgia
Músculo Esquelético/cirurgia
Nervo Ulnar/cirurgia
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170515
[St] Status:MEDLINE



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