Horizontal distribution of invertebrate larvae around the oceanic island of Gran Canaria: the effect of mesoscale variability

In October 1991, the horizontal distribution of invertebrate larvae was studied in the waters surrounding the island of Gran Canaria (Canary Islands). The cruise was typified by the presence of three recurrent mesoscale hydrographic structures: a cyclonic eddy southwest of the island, a warm lee region downstream of the island and the offshore boundary of an upwelling filament from the African coast reaching the southeast of the island. Decapod larvae were the most abundant group. In general, a rather high spatial variability was found. The horizontal distribution of the invertebrate larvae groups showed that the highest values of abundance occurred in an elongated zone around the island oriented in the overall direction of flow, leeward and windward of the island, while the lowest values occurred off the eastern and western flanks of the islands. On the other hand, Stomatopoda and Mollusca larvae showed a distribution associated with the boundary of the upwelling filament and decapod larvae of pelagic species were distributed around the eddy structure. Our results suggest specific retention mechanisms for the larvae of neritic invertebrate populations that are related to the particular physical oceanography around Gran Canaria. Se estudió la distribución horizontal de las larvas de invertebrados alrededor de la isla de Gran Canaria (Islas Canarias) en octubre de 1991. La campaña se caracterizó por la presencia de tres fenómenos oceanográficos de mesoescala recurrentes: un remolino ciclónico al suroeste de la isla, la estela cálida a sotavento de la misma y el borde de un filamento proveniente del afloramiento africano situado al sureste de Gran Canaria. Las larvas de crustáceos decápodos fueron las más abundantes. En general, las larvas de los diferentes taxa estudiados mostraron una gran variabilidad en cuanto a su distribución espacial. La distribución horizontal de las larvas de los diferentes grupos de invertebrados mostró que las densidades más altas se registraban alrededor de la isla en la banda cercana y orientada hacia el suroeste, en la dirección del flujo, mientras que los valores más bajos se encontraron en el norte y en los flancos este y oeste de la isla. Por otro lado, las larvas de estomatópodos y moluscos presentaron una distribución asociada al frente del filamento, mientras que las larvas de decápodos pelágicos se distribuyeron en torno al remolino ciclónico. Los resultados obtenidos sugieren la existencia de mecanismos de retención específicos para el mantenimiento de las poblaciones insulares, relacionados con los procesos físicos de mesoescala predominantes

What is the diagnostic value of ultrasonography compared to physical evaluation in patients with idiopathic carpal tunnel syndrome?

[EN] OBJECTIVE: Our hypothesis is that sonography performed by the rheumatologist in patients with suspected carpal tunnel syndrome (CTS) has higher diagnostic value compared to physical evaluation. METHODS: Adult patients with suspected idiopathic CTS, defined by sensory symptoms over the distribution of the median nerve with or without positive results with the Phalen and/or the Tinel's maneuvers were included. The diagnosis of CTS was indicated by typical symptoms daily for at least 3 months and a positive nerve conduction study. One rheumatologist unaware of the clinical and electrodiagnostic results performed an ultrasound examination of the median nerve for the area ranging from the inlet to the outlet of the carpal tunnel. Mean cross-sectional area at each level, flattening ratio and bowing of flexor retinaculum were obtained. RESULTS: Sixty-eight patients with 105 affected wrists were examined. Tinel's and Phalen's signs had a closer sensitivity (73% and 67% respectively) and specificity (40% and 30% respectively). The best swelling nerve cut-off by sonography was 9.7 mm2 at the tunnel inlet, with a sensitivity of 86%, a specificity of 48% and accuracy of 77%. A 100% positive predictive value was reached with a cross-sectional area of 13 mm2, involving 33 hands (31% of the whole sample). Maximal cross sectional area and the measurement of flexor retinaculum had an accuracy of 72% and 73% respectively. Combination of physical maneuvers and sonography not yielded more accuracy than cross-sectional area itself. CONCLUSION: In patients with clinical history of idiopathic CTS and positive nerve conduction study, sonography performed by the rheumatologist has higher diagnostic value than physical maneuvers.