RESUMEN
Carpal tunnel syndrome (CTS) has become the industrial epidemic syndrome of the decade and its incidence is continuing to rise. Because of public awareness. CTS is being diagnosed much earlier in the course of the disease. Iontophoresis of dexamethasone sodium phosphate has been used for years in the treatment of many musculoskeletal inflammatory disorders and clinicians have reported using this modality in the treatment of CTS. Iontophoresis is a method of transdermal administration of ionized drugs in which electrically charged molecules are propelled through the skin by an external electrical field. However, conditions of treatment and evaluation have not been standardized. A prospective, nonrandomized study utilizing a standardized treatment protocol incorporating wrist splinting with nonsteroidal antiinflammatory medications and iontophoresis of dexamethasone sodium phosphate revealed a success rate comparable with splinting plus injection of dexamethasone into the carpal tunnel space. In a 6-month follow-up of 23 cases (hands) of early-mild CTS, 4 of 23 hands (17%) were successfully treated with splints plus nonsteroidal antiinflammatory medications alone. Of those that failed this treatment program and chose to proceed with iontophoresis of dexamethasone, 11 of 19 hands (58%) had a positive response rate to iontophoresis, leaving a combined failure rate (failing both splints, nonsteroidal antiinflammatory medications and iontophoresis) of 35%. Iontophoresis may become an alternative to steroid injections to the carpal tunnel region if further studies substantiate these findings. It provides an excellent complication and side-effect profile compared with other methods of delivering dexamethasone. No complications occurred (including no significant elevation of serum glucose in insulin-dependent diabetics.)
Asunto(s)
Síndrome del Túnel Carpiano/rehabilitación , Dexametasona/administración & dosificación , Ibuprofeno/administración & dosificación , Iontoforesis , Enfermedades Profesionales/rehabilitación , Férulas (Fijadores) , Adulto , Anciano , Terapia Combinada , Dexametasona/efectos adversos , Femenino , Humanos , Ibuprofeno/efectos adversos , Inyecciones Intraarticulares , Masculino , Persona de Mediana Edad , Examen Neurológico/efectos de los fármacosRESUMEN
A 2-year 10-month old girl developed eosinophilic fasciitis that resolved within one year after the administration of prednisone. She was left with changes similar to chronic linear scleroderma. Our case illustrates that eosinophilic fasciitis can occur in very young children and reinforces the hypothesis that it may be an early manifestation of scleroderma.
Asunto(s)
Eosinofilia/etiología , Fascitis/etiología , Esclerodermia Localizada/complicaciones , Preescolar , Eosinofilia/tratamiento farmacológico , Fascitis/tratamiento farmacológico , Femenino , Humanos , Prednisona/uso terapéuticoRESUMEN
This study examines effects of variations in fiber content on nutrient assimilation, fecal output, and gastrointestinal transit time in the dog. Four normal Beagles were fed four diets in a randomized block design. The basal diet was a canned, balanced, meat-based dog food (Alpo Trio) to which added 3, 6, and 9% by weight of alpha cellulose (Solka Flok). Food intake and fecal outputs were recorded for 5-day periods. Samples of diets and fecal collections were analyzed for dry matter, nitrogen, fat, carbohydrate and ash; digestibilities were calculated. Transit times were measured by a radiographic marker technique. Fecal weight and water increased linearly; digestibility of dry matter decreased from 90 to 70% and ash from 43 to 32% with added fiber. Responses of protein, carbohydrate and fat were less pronounced but were regular; regressions of their digestibilities on added fiber were significant. Regression estimate of true digestibility for alpha-cellulose was 6%. Intestinal transit time decreased from a mean of 37.4 to 28.7 hours with added fiber. Decreased intestinal time would contribute to depression of fry matter digestibility. Increased fecal water output probably also reflected retention by fiber.