The natural history of carpal tunnel syndrome: A study of 20 hands evaluated 4 to 9 years after initial diagnosis

Carpal tunnel syndrome (CTS) is the most frequent entrapment neuropathy. In the last decade several papers have been published on epidemiology, clinical aspects, diagnosis, and treatment, but little is known about its natural history. The objective of this work was to study the natural history of CTS syndrome. From 358 patients with clinical and conduction study diagnosis of CTS, 12 cases were identified that had refused surgical treatment, had not used anti-inflammatory medications, and had not undergone orthopaedic procedures, such as immobilization or anaesthetic infiltration. These 12 patients have 20 compromised hands which have been followed up for between 4 and 9 years. In all cases sensory and motor conduction studies were performed on the median nerve, at the beginning and end of follow-up period. Electrical improvement was marked in 5 hands and slight in 3; there was no significant change in 10, and deterioration in 2. As 8 hands (7 patients) showed improved clinical symptoms and conduction studies over several years, this brings the universally accepted procedure of surgical treatment into doubt.

Treatment of developmental defect of upper lip with carbon dioxide laser radiation (CO2): First surgical time

With the exception of the cleft lip, developmental defects (DD) of the lip are rare. The upper lip originates from the ectomesenchyme and is formed by the merging of the nasal medial and lateral processes with the maxillary process. Disturbances during this formation period can cause DD with functional and/or esthetic repercussions. We present a case of DD of the upper lip in a patient with a history of progressive growth of the left lateral portion of the upper lip that occurred from the time of birth until the age of 22 years. Clinical examination revealed hypertrophy of the area from the left philtral columns to the left commissure of the lip, extending the portion of the surface mucosa creating a flaccid and asymptomatic tissue mass. All other buccal structures appeared to be within normal limits and without any evidence of defects or deformities. In the surgical planning we decided to carry out corrective surgery in two phases. The first phase accomplished a conservative excision of the total abnormal labial tissue mass with a CO2 laser radiation (5 W in continuous mode, bunch diameter φ = 0.6 mm with a power density of 768 W/cm2 and fluency of 0.231 J/cm2) being careful to preserve the vermilion portion of the lip. Postsurgical clinical evaluations were done every three days until the skin sutures were removed and then every seven days until two months post surgery. While the entire mass of excessive tissue could not be completely removed, the removal of the excessive mucosal tissue produced a very good outcome relative to lip function, with a good esthetic result without scarring, and good tissue mobility. The results showed that the CO2 laser is an extremely useful instrument that can provide excellent control of the surgical field and allow for healing that produces excellent functional and esthetic results. © 2005 Taylor & Francis.

The ongoing history of a Chilean metal products and machinery firm

Includes bibliography

Prognostic factors associated with time to hCG remission in patients with low-risk postmolar gestational trophoblastic neoplasia

Objective The purpose of this study was to identify the clinical factors associated with time to hCG remission among women with low-risk postmolar GTN. Methods This study included a non-concurrent cohort of 328 patients diagnosed with low-risk postmolar GTN according to FIGO 2002 criteria. Associations of time to hCG remission with history of prior mole, molar histology, time to persistence, use of D&C at persistence, presence of metastatic disease, FIGO score, hCG values at persistence, type of first line therapy and use of multiagent chemotherapy were investigated with both univariate and multivariate analyses. Results Overall median time to remission was 46 days. Ten percent of the patients required multi-agent chemotherapy to achieve hCG remission. Multivariate analysis incorporating the variables significant on univariate analysis confirmed that complete molar histology (HR 1.45), metastatic disease (HR 1.66), use of multi-agent therapy (HR 2.00) and FIGO score (HR 1.82) were associated with longer time to remission. There was a linear relationship between FIGO score and time to hCG remission. Each 1-point increment in FIGO score was associated with an average 17-day increase in hCG remission time (95% CI: 12.5-21.6). Conclusions Complete mole histology prior to GTN, presence of metastatic disease, use of multi-agent therapy and higher FIGO score were independent factors associated with longer time to hCG remission in low-risk GTN. Identifying the prognostic factors associated with time to remission and effective counseling may help improve treatment planning and reduce anxiety in patients and their families. © 2013 Elsevier Inc. All rights reserved.

The Phylogeographic History of the New World Screwworm Fly, Inferred by Approximate Bayesian Computation Analysis

Insect pest phylogeography might be shaped both by biogeographic events and by human influence. Here, we conducted an approximate Bayesian computation (ABC) analysis to investigate the phylogeography of the New World screwworm fly, Cochliomyia hominivorax, with the aim of understanding its population history and its order and time of divergence. Our ABC analysis supports that populations spread from North to South in the Americas, in at least two different moments. The first split occurred between the North/Central American and South American populations in the end of the Last Glacial Maximum (15,300-19,000 YBP). The second split occurred between the North and South Amazonian populations in the transition between the Pleistocene and the Holocene eras (9,100-11,000 YBP). The species also experienced population expansion. Phylogenetic analysis likewise suggests this north to south colonization and Maxent models suggest an increase in the number of suitable areas in South America from the past to present. We found that the phylogeographic patterns observed in C. hominivorax cannot be explained only by climatic oscillations and can be connected to host population histories. Interestingly we found these patterns are very coincident with general patterns of ancient human movements in the Americas, suggesting that humans might have played a crucial role in shaping the distribution and population structure of this insect pest. This work presents the first hypothesis test regarding the processes that shaped the current phylogeographic structure of C. hominivorax and represents an alternate perspective on investigating the problem of insect pests. © 2013 Fresia et al.

The Panama Canal turns 100: history and possible future scenarios

This issue of the FAL Bulletin sets out a brief history of the Panama Canal, its construction and its social and political impact on Panama, within the context of international trade at the time. This issue also reviews the recovery of the canal by the Republic of Panama and subsequent major events, including the decision to expand the canal and the start-up of work on the expansion project.

Electromyographic reaction time in older female fallers and non-fallers after postural perturbation

O tempo de reação eletromiográfica (TRE) reflete a magnitude e a velocidade com que os músculos são ativados para realizar movimentos, evitar lesões ou posicionar uma articulação e pode ser avaliado após uma perturbação externa para análise do desempenho do controle postural e relacioná-lo com a possibilidade de quedas em idosos. O objetivo do estudo foi verificar o TRE dos músculos oblíquo interno (OI), reto femoral (RF), vasto lateral (VL), tibial anterior (TA), multífido (MU), glúteo máximo (GM), bíceps femoral (BF) e gastrocnêmio lateral (GL) em situações de perturbação do equilíbrio em idosos com e sem histórico de quedas. Para isso, foram avaliadas vinte e nove mulheres com 60 anos ou mais, fisicamente ativas e não-institucionalizadas e separadas em dois grupos de acordo com o relato de quedas nos 12 meses pregressos ao estudo: Grupo de Idosas Caidoras (GIC) (n=13; 72,4 ± 8,0 anos) e Grupo de Idosas Não-Caidoras (GINC) (n=16; 67,8 ± 6,8 anos). O TRE dos músculos avaliados durante o teste de desequilíbrio postural anterior e posterior não foram significativamente diferentes entre os grupos. Os resultados sugerem que a ativação muscular dos músculos avaliados, tanto durante o desequilíbrio anterior quanto no desequilíbrio posterior, não podem ser considerados um fator determinante para quedas.

Insights on the HLA-G Evolutionary History Provided by a Nearby Alu Insertion

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Diversity, natural history, and geographic distribution of snakes in the Caatinga, Northeastern Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Molecular Phylogeny and Biogeographic History of the Armored Neotropical Catfish Subfamilies Hypoptopomatinae, Neoplecostominae and Otothyrinae (Siluriformes: Loricariidae)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Life-history strategies associated to reproduction of three Hyphessobrycon species (Characidae) in lentic environments of upper Paraná River basin

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Life history and DNA barcode of Oxyurella longicaudis (Birgei, 1910) (Cladocera, Anomopoda, Chydoridae)

Background: Cladocera is an important group of freshwater zooplankton, and the species plays an important role in energy transfer and in aquatic food webs. Oxyurella longicaudis is a Chydoridae species that has been recorded in North and South America. The aim of this study is to investigate the life cycle aspects of parthenogenetic females of O. longicaudis cultured in laboratory under controlled conditions: temperature (23 degrees C +/- 05 degrees C), photoperiod (12 h light/12 h dark), food supply, and reconstituted water.Results: Embryonic development duration (2.3 +/- 0.5 days), post-embryonic development (5.2 +/- 0.69 days), mean fecundity (two eggs female(-1) brood(-1)), total egg production (22.55 +/- 3.98 eggs), average longevity (58 days), and body growth of the species were recorded. We also report the first DNA barcode for O. longicaudis isolated in Brazil, which will allow for easy identification in future zooplankton community studies. The analysis shows a genetic divergence of around 7% between our Brazilian isolate and O. longicaudis isolates from Mexico.Conclusions: The time of embryonic and post-embryonic development of O. longicaudis was higher than that of the other species of the same family, which contributed to lower total egg production throughout its life cycle. The genetic divergence appears to be sufficient to classify the two isolates as different species.

Spatiotemporal variation in life history traits of three small fishes in streams of south-eastern Brazil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Does the rattle of Crotalus durissus terrificus reveal its dietary history?

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Diversification events and the effects of mass extinctions on Crocodyliformes evolutionary history

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)