Evaluation of patients with carpal tunnel syndrome treated by endoscopic technique

Objective:To evaluate the postoperative results of patients with carpal tunnel syndrome by the endoscopic release technique with single portal.Methods:78 patients (80 wrists) were evaluated preoperatively and postoperatively at 1, 3 and 6 months by the Boston questionnaire, the visual analogue scale (VAS) for pain, monofilament test sensitivity, grip strength, lateral pinch, pulp to pulp pinch and tripod pinch.Results:Statistical analysis was significant (p <0.05) in the progressive decline of pain and improved function (Boston) during follow-up. The sensitivity significantly improved comparing the data pre and postoperatively. The grip strength, lateral pinch, pulp to pulp pinch and tripod pinch decreased in the first month after surgery, returning to preoperative values around the third month postoperatively.Conclusion:The technique proved to be safe and effective in improving pain, function, and return sensitivity and strength. Level of Evidence II, Prospective studyUniversidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

HOW DO BOARD-CERTIFIED HAND SURGEONS MANAGE CARPAL TUNNEL SYNDROME? A NATIONAL SURVEY

ABSTRACT Objective: To evaluate tendencies in the planning, diagnosis, and treatment of carpal tunnel syndrome (CTS) by Brazilian hand surgery specialists. Methods: This cross-sectional study was performed at the 36th Brazilian Hand Surgery Congress. We prepared a questionnaire about preferences in the management of CTS, and board-certified hand surgeons that attended the congress were asked to fill out the questionnaires. A total of 174 questionnaires were analyzed. Results: Electromyography examination is used by most surgeons. Night splinting is the most commonly used conservative treatment option. Half of the surgeons utilized prophylactic antibiotics. Most of the interviewees conduct inpatient surgery in the operating room and prefer intravenous regional anesthesia. Most of surgeons use the standard open technique associated with proximal release of the antebrachial fascia and do not perform neurolysis. Compressive dressings are most commonly used for 7 days. Conclusion: The approach to CTS among Brazilian hand surgeons with regard to pre-, intra-, and post-operatory conduct is consistent with the international literature. However, there is a need to reflect and conduct new studies on non-surgical treatment involving local corticosteroid injection, use of prophylactic antibiotics, hospital admission, and type of anesthesia in order to provide more cost-effective approach to surgical treatment for CTS. Level of Evidence V; Expert opinion.</div

ATLAS Run 1 searches for direct pair production of third-generation squarks at the Large Hadron Collider

This paper reviews and extends searches for the direct pair production of the scalar supersymmetric partners of the top and bottom quarks in proton-proton collisions collected by the ATLAS collaboration during the LHC Run 1. Most of the analyses use 20 fb$^{-1}$ of collisions at a centre-of-mass energy of $\sqrt{s}$ = 8 TeV, although in some case an additional 4.7 fb$^{-1}$ of collision data at $\sqrt{s}$ = 7 TeV are used. New analyses are introduced to improve the sensitivity to specific regions of the model parameter space. Since no evidence of third-generation squarks is found, exclusion limits are derived by combining several analyses and are presented in both a simplified model framework, assuming simple decay chains, as well as within the context of more elaborate phenomenological supersymmetric models

Above-versus below-elbow casting for conservative treatment of distal radius fractures: a randomized controlled trial

Introdução: Embora a fratura do rádio distal seja uma das mais frequentes do membro superior, o melhor método de imobilização dessas fraturas ainda não foi definido. Objetivo: Avaliar a efetividade do tratamento conservador, com tala longa (TL), em comparação com a tala curta (TC), considerando-se a função do membro superior medido pelo DASH na 24ª semana após a redução da fratura do rádio distal. Método: Ensaio clínico randomizado. Foram avaliadas duas intervenções não cirúrgicas: TL e TC. Um total de 128 pacientes adultos com fraturas agudas, desviadas, classificadas em AO 23A2-3, C1-3 foram incluídos. O desfecho primário foi o questionário DASH na 24ª semana. Como desfechos secundários, analisaram se a manutenção da redução da fratura, a dor pela escala visual analógica, o PRWE, a avaliação funcional e a taxa de efeitos adversos. Resultados: Não houve diferença entre os grupos nas avaliações do questionário DASH na 24ª semana. O grupo tala curta apresentou uma uma diminuição significativa no escore DASH de duas semanas; p < 0,001. A avaliação funcional objetiva, as taxas de perda de redução, a função do punho medida pelo PRWE, a média de dor no punho, cotovelo e ombro foram clinicamente semelhantes entre os grupos. A tala acima do cotovelo resultou em mais efeitos adversos. Conclusão: Não houve diferença no tratamento com TL e TC, quanto à função medida pelo DASH do membro superior após 6 meses. No entanto, a TC foi menos debilitante durante o tratamento e igualmente eficaz em comparação à TL na manutenção da redução da fratura com menos efeitos adversos.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)2019/04546-

A systematic review of the quality of distal radius systematic reviews: Methodology and reporting assessment.

BackgroundMany systematic reviews (SRs) have been published about the various treatments for distal radius fractures (DRF). The heterogeneity of SRs results may come from the misuse of SR methods, and literature overviews have demonstrated that SRs should be considered with caution as they may not always be synonymous with high-quality standards. Our objective is to evaluate the quality of published SRs on the treatment of DRF through these tools.MethodsThe methods utilized in this review were previously published in the PROSPERO database. We considered SRs of surgical and nonsurgical interventions for acute DRF in adults. A comprehensive search strategy was performed in the MEDLINE database (inception to May 2017) and we manually searched the grey literature for non-indexed research. Data were independently extracted by two authors. We assessed SR internal validity and reporting using AMSTAR (Assessing the Methodological Quality of Systematic Reviews and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyzes). Scores were calculated as the sum of reported items. We also extracted article characteristics and provided Spearman's correlation measurements.ResultsForty-one articles fulfilled the eligibility criteria. The mean score for PRISMA was 15.90 (CI 95%, 13.9-17.89) and AMSTAR was 6.48 (CI 95% 5.72-7.23). SRs that considered only RCTs had better AMSTAR [7.56 (2.1) vs. 5.62 (2.3); p = 0.014] and PRISMA scores [18.61 (5.22) vs. 13.93 (6.47), p = 0.027]. The presence of meta-analysis on the SRs altered PRISMA scores [19.17 (4.75) vs. 10.21 (4.51), p = 0.001] and AMSTAR scores [7.68 (1.9) vs. 4.39 (1.66), p = 0.001]. Journal impact factor or declaration of conflict of interest did not change PRISMA and AMSTAR scores. We found substantial inter observer agreement for PRISMA (0.82, 95% CI 0.62-0.94; p = 0.01) and AMSTAR (0.65, 95% CI 0.43-0.81; p = 0.01), and moderate correlation between PRISMA and AMSTAR scores (0.83, 95% CI 0.62-0.92; p = 0.01).ConclusionsDRF RCT-only SRs have better PRISMA and AMSTAR scores. These tools have substantial inter-observer agreement and moderate inter-tool correlation. We exposed the current research panorama and pointed out some factors that can contribute to improvements on the topic