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Liñan-Padilla A, Berlanga-Porras A, Jiménez I. Relationship between median nerve vascularization before tourniquet release and the Boston Carpal Tunnel Questionnaire: a cohort study. J Hand Surg Eur Vol 2024:17531934241248066. [PMID: 38641942 DOI: 10.1177/17531934241248066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
The results of this study suggest that a decreased vascularization of the median nerve after releasing the carpal tunnel predicts an inferior clinical improvement assessed by the Boston Carpal Tunnel Questionnaire.
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Affiliation(s)
- Alejandro Liñan-Padilla
- Hand Surgery Unit, Department of Orthopedic Surgery, Hospital San Juan de Dios del Aljarafe, Bormujos (Sevilla), Spain
| | - Alejandro Berlanga-Porras
- Hand Surgery Unit, Department of Orthopedic Surgery, Hospital San Juan de Dios del Aljarafe, Bormujos (Sevilla), Spain
| | - Isidro Jiménez
- Department of Orthopaedic Surgery, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
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Aniel-Quiroga M, Fruner G, Monge-Baeza A, García-Toledo A, Liñán-Padilla A, Jiménez I. The hematoma block is not enough as method of anesthesia in reduction of displaced distal radius fractures. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023; 67:371-377. [PMID: 36898432 DOI: 10.1016/j.recot.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 03/01/2023] [Accepted: 03/05/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Two out of three wrist fractures seen in the emergency are displaced but most can be treated conservatively after closed reduction. Patient-reported pain during closed reduction of distal radius fractures varies widely and the best method to decrease the perceived pain has not been well established. The purpose of this study was to assess the pain during closed reduction of distal radius fractures after using the hematoma block as method of anaesthesia. PATIENTS AND METHODS Cross-sectional clinical study including all patients who presented an acute fracture of the distal radius requiring closed reduction and immobilization during a six-month period in two University Hospitals. Demographic data, fracture classification, perceived pain using a visual analog scale at different times of reduction and complications were registered. RESULTS Ninety-four consecutive patients were included. Mean age was 61 years. Mean pain score at initial assessment was 6 points. After the hematoma block, the perceived pain during the reduction manoeuvre improved to 5.1 points at the wrist, but increased to 7.3 points at the fingers. Pain decreased to 4.9 points during cast placement and reached 1.4 point after sling placement. The reported pain was higher in women at all times. There were no significant differences according to the according to the type of fracture. No neurological or skin complications were observed. CONCLUSIONS The hematoma block is only a mild effective method to reduce the wrist pain during closed reduction of distal radius fractures. This technique decreases slightly the perceived pain in the wrist and does not reduce the pain in the fingers. Other reduction methods or other analgesic techniques may be more effective options. LEVEL OF EVIDENCE Therapeutic study. Cross-sectional study - Level IV.
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Affiliation(s)
- M Aniel-Quiroga
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España
| | - G Fruner
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España
| | - A Monge-Baeza
- Servicio de Cirugía Ortopédica y Traumatología, Hospital San Juan de Dios del Aljarafe, Sevilla, España
| | - A García-Toledo
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España
| | - A Liñán-Padilla
- Servicio de Cirugía Ortopédica y Traumatología, Hospital San Juan de Dios del Aljarafe, Sevilla, España
| | - I Jiménez
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España; Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España.
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Aniel-Quiroga M, Fruner G, Monge-Baeza A, García-Toledo A, Liñán-Padilla A, Jiménez I. [Translated article] The haematoma block is not enough as method of anaesthesia in reduction of displaced distal radius fractures. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023; 67:T371-T377. [PMID: 37311480 DOI: 10.1016/j.recot.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 03/05/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Two out of three wrist fractures seen in an emergency department are displaced but most can be treated conservatively after closed reduction. Patient-reported pain during closed reduction of distal radius fractures varies widely and the best method to decrease the perceived pain has not been well established. The purpose of this study was to assess pain during closed reduction of distal radius fractures after using haematoma block as method of anaesthesia. PATIENTS AND METHODS Cross-sectional clinical study including all patients who presented an acute fracture of the distal radius requiring closed reduction and immobilisation during a six-month period in two University Hospitals. Demographic data, fracture classification, perceived pain using a visual analogue scale at different times of reduction and complications were registered. RESULTS Ninety-four consecutive patients were included. Mean age was 61 years. Mean pain score at initial assessment was 6 points. After the haematoma block, the perceived pain during the reduction manoeuvre improved to 5.1 points at the wrist, but increased to 7.3 points at the fingers. Pain decreased to 4.9 points during cast placement and reached 1.4 point after sling placement. The reported pain was higher in women at all times. There were no significant differences according to the according to the type of fracture. No neurological or skin complications were observed. CONCLUSIONS Haematoma block is only a mildly effective method to reduce wrist pain during closed reduction of distal radius fractures. This technique slightly decreases the perceived pain in the wrist and does not reduce the pain in the fingers. Other reduction methods or other analgesic techniques may be more effective options. LEVEL OF EVIDENCE Therapeutic study. Cross-sectional study - Level IV.
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Affiliation(s)
- M Aniel-Quiroga
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - G Fruner
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - A Monge-Baeza
- Servicio de Cirugía Ortopédica y Traumatología, Hospital San Juan de Dios del Aljarafe, Sevilla, Spain
| | - A García-Toledo
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - A Liñán-Padilla
- Servicio de Cirugía Ortopédica y Traumatología, Hospital San Juan de Dios del Aljarafe, Sevilla, Spain
| | - I Jiménez
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain; Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
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Ripollés-Melchor J, Aldecóa C, Lorente JV, Ruiz-Escobar A, Monge-García MI, Jiménez I, Jover-Pinillos JL, Galán-Menendez P, Tomé-Roca JL, Fernández-Valdes-Balgo P, Colomina MJ. Fluid challenges in operating room: A planned sub study of the Fluid Day observational study. Rev Esp Anestesiol Reanim (Engl Ed) 2023; 70:311-318. [PMID: 37276966 DOI: 10.1016/j.redare.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/21/2022] [Indexed: 06/07/2023]
Abstract
BACKGROUND Intraoperative fluid administration is a ubiquitous intervention in surgical patients. But inadequate fluid administration may lead to poor postoperative outcomes. Fluid challenges (FCs), in or outside the so-called goal-directed fluid therapy, allows testing the cardiovascular system and the need for further fluid administration. Our primary aim was to evaluate how anesthesiologists conduct FCs in the operating room in terms of type, volume, variables used to trigger a FC and to compare the proportion of patients receiving further fluid administration based on the response to the FC. METHODS This was a planned substudy of an observational study conducted in 131 centres in Spain in patients undergoing surgery. RESULTS A total of 396 patients were enrolled and analysed in the study. The median [interquartile range] amount of fluid given during a FC was 250ml (200-400). The main indication for FC was a decrease in systolic arterial pressure in 246 cases (62.2%). The second was a decrease in mean arterial pressure (54.4%). Cardiac output was used in 30 patients (7.58%), while stroke volume variation in 29 of 385 cases (7.32%). The response to the initial FC did not have an impact when prescribing further fluid administration. CONCLUSIONS The current indication and evaluation of FC in surgical patients is highly variable. Prediction of fluid responsiveness is not routinely used, and inappropriate variables are frequently evaluated for assessing the hemodynamic response to FC, which may result in deleterious effects.
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Affiliation(s)
- J Ripollés-Melchor
- Department of Anesthesia and Critical Care, Hospital Universitario Infanta Leonor, Madrid, Spain; Fluid Therapy and Hemodynamic Monitoring Group of the Spanish Society of Anesthesiology and Critical Care (SEDAR), Spain.
| | - C Aldecóa
- Fluid Therapy and Hemodynamic Monitoring Group of the Spanish Society of Anesthesiology and Critical Care (SEDAR), Spain; Department of Anesthesiology and Surgical Critical Care, Hospital Universitario Rio Hortega, Valladolid, Spain
| | - J V Lorente
- Fluid Therapy and Hemodynamic Monitoring Group of the Spanish Society of Anesthesiology and Critical Care (SEDAR), Spain; Department of Anesthesia and Critical Care, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain
| | - A Ruiz-Escobar
- Department of Anesthesia and Critical Care, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - M I Monge-García
- Department of Anesthesia and Critical Care, Hospital Universitario Infanta Leonor, Madrid, Spain; Edwards Lifesciences, Irvine, California, United States
| | - I Jiménez
- Fluid Therapy and Hemodynamic Monitoring Group of the Spanish Society of Anesthesiology and Critical Care (SEDAR), Spain; Department of Anesthesia, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - J L Jover-Pinillos
- Fluid Therapy and Hemodynamic Monitoring Group of the Spanish Society of Anesthesiology and Critical Care (SEDAR), Spain; Department of Anesthesia, Hospital Verge dels Lliris, Alcoy, Alicante, Spain
| | - P Galán-Menendez
- Fluid Therapy and Hemodynamic Monitoring Group of the Spanish Society of Anesthesiology and Critical Care (SEDAR), Spain; Department of Anesthesia, Hospital Universitario Vall d'Hebrón, Barcelona, Spain
| | - J L Tomé-Roca
- Fluid Therapy and Hemodynamic Monitoring Group of the Spanish Society of Anesthesiology and Critical Care (SEDAR), Spain; Department of Anesthesia, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - P Fernández-Valdes-Balgo
- Department of Anesthesia and Critical Care, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - M J Colomina
- Fluid Therapy and Hemodynamic Monitoring Group of the Spanish Society of Anesthesiology and Critical Care (SEDAR), Spain; Department of Anesthesia and Critical Care, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
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Jiménez I, de Santos D, Medina J. Extensor tendon reconstruction for Zone I injuries using a distally based tendon flap. J Hand Surg Eur Vol 2022; 47:1077-1078. [PMID: 36165565 DOI: 10.1177/17531934221126873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Isidro Jiménez
- Department of Orthopaedic Surgery, Hospital Universitario Insular de Gran Canaria and Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Daniel de Santos
- Department of Orthopaedic Surgery, Hospital Universitario Insular de Gran Canaria and Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - José Medina
- Department of Orthopaedic Surgery, Hospital Universitario Insular de Gran Canaria and Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
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Jiménez I, Medina J, Marcos-García A, Garcés G. [Translated article] Out-of-sheath corticosteroid injections through the dorsal webspace for trigger finger and trigger thumb. A prospective cohort study. Rev Esp Cir Ortop Traumatol (Engl Ed) 2022. [DOI: 10.1016/j.recot.2021.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Jiménez I, Medina J, Marcos-García A, Garcés GL. Out-of-sheath corticosteroid injections through the dorsal webspace for trigger finger and trigger thumb. A prospective cohort study. Rev Esp Cir Ortop Traumatol (Engl Ed) 2021; 66:260-266. [PMID: 34366261 DOI: 10.1016/j.recot.2021.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/16/2021] [Accepted: 03/20/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Steroid injections are effective in the treatment of trigger digits but the pain during the injection is an always-present accompanying effect. The aim of this study was to assess the effectiveness and perceived pain during an out-of-sheath corticosteroid injection through the dorsal webspace in the treatment of trigger digits. MATERIAL AND METHOD A total of 126 consecutive patients were included. A subcutaneous (out-of-sheath) corticosteroid injection was performed through the dorsal webspace in all digits. In cases where signs or symptoms persisted, a second injection was offered. Visual analog scale for pain during the injection, DASH questionnaire, success rate and complications were collected. RESULTS There were 86 women and 40 men with a mean age of 61 years. The mean visual analog scale for pain during the injection was 3.8. Twelve patients were lost to follow-up. The overall success was 68% and success after a single injection was 54%. The best result was achieved on the ring finger. Patients who were not previously operated on carpal tunnel syndrome responded better. No complications were noted. CONCLUSIONS The extra-sheath corticosteroid injection through the dorsal webspace is effective and safe. It seems to be less painful than the reported scores for the palmar midline technique although it should be assessed in a comparative study.
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Affiliation(s)
- I Jiménez
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, España; Departamento de Ciencias Médicas y Quirúrgicas, Facultad de Medicina, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, España.
| | - J Medina
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, España; Departamento de Ciencias Médicas y Quirúrgicas, Facultad de Medicina, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, España
| | - A Marcos-García
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, España; Departamento de Ciencias Médicas y Quirúrgicas, Facultad de Medicina, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, España
| | - G L Garcés
- Departamento de Ciencias Médicas y Quirúrgicas, Facultad de Medicina, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, España; Servicio de Cirugía Ortopédica y Traumatología, Hospital Perpetuo Socorro, Las Palmas de Gran Canaria, Las Palmas, España
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Jiménez I, Muratore G, Marcos-García A. [Coraco-clavicular loop and tension band suture in type II and type V distal-third clavicle fractures]. Acta Ortop Mex 2021; 35:236-239. [PMID: 34731930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Many surgical techniques have been used to address unstable distal third clavicle fractures. Complications and the need for hardware removal are still a concern. We propose a surgical technical using high-strength sutures to restore vertical and horizontal stability in Neer type II and Neer type V distal-third clavicle fractures. It has been used in three cases; two type V and one type II. In all cases, bone healing was achieved uneventfully and all patients resumed their pre-injury activities including sports at sixmonths postoperatively. The coraco-clavicular loop and tension band suture technique is a simple procedure that allows vertical and horizontal stabilization of the fracture. It achieves good clinical results and it may be a costeffective alternative to other techniques although a longer series and longterm followup is required to adequately assess the results.
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Affiliation(s)
- I Jiménez
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria. Las Palmas de Gran Canaria, España
| | - G Muratore
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria. Las Palmas de Gran Canaria, España
| | - A Marcos-García
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria. Las Palmas de Gran Canaria, España
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Jiménez I, Medina-Gontier J, Caballero J, Medina J. Hand Deformities in Hajdu-Cheney Syndrome: A Case Series of 3 Patients Across 3 Consecutive Generations. J Hand Surg Am 2021; 46:73.e1-73.e5. [PMID: 32241674 DOI: 10.1016/j.jhsa.2020.02.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 10/20/2019] [Accepted: 02/14/2020] [Indexed: 02/02/2023]
Abstract
Hajdu-Cheney syndrome is a rare condition characterized by acro-osteolysis, osteoporosis, and multiple craniofacial anomalies. The goal of treatment is to reduce the associated symptoms and to prevent osteoporotic fractures. This is a report of 3 patients across consecutive generations demonstrating variable phenotypic severity. The hand surgeon was the first medical care provider visited by the patients because of the shortening of the fingers.
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Affiliation(s)
- Isidro Jiménez
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain; Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
| | | | - Jonathan Caballero
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - José Medina
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain; Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
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Jiménez I, Garcés GL, Marcos-García A, Medina J. A randomized controlled trial of dorsal web space versus palmar midline injection of steroid in the treatment of trigger digits. J Hand Surg Eur Vol 2020; 45:1071-1077. [PMID: 32493111 DOI: 10.1177/1753193420927999] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
One hundred and sixty patients were enrolled in a prospective randomized controlled trial to assess whether a steroid injection through the dorsal web space was less painful than the palmar midline technique in the treatment of trigger digits and whether they were equally effective. There were 116 women and 44 men with a mean age of 60 years. The mean visual analogue score for pain during the injection was 3.6 in the dorsal web space group and 5.4 in the palmar midline group on a scale of 0-10. The overall success of treatment in the dorsal group was 67%, whereas it was 56% in the palmar group. No complications were noted. We concluded from this study that the dorsal web space technique is less painful and at least as effective as the palmar midline technique.Level of evidence: I.
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Affiliation(s)
- Isidro Jiménez
- Department of Orthopaedic Surgery, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain.,School of Medicine. Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Gerardo L Garcés
- School of Medicine. Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Department of Orthopaedic Surgery, Hospital Perpetuo Socorro, Las Palmas de Gran Canaria, Spain
| | - Alberto Marcos-García
- Department of Orthopaedic Surgery, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain.,School of Medicine. Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - José Medina
- Department of Orthopaedic Surgery, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain.,School of Medicine. Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
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Jiménez I, Muratore G, Marcos-García A. The functional role of the palmar aponeurosis and A1 pulley in proximal zone 2 flexor tendon repairs: a case report. J Hand Surg Eur Vol 2020; 45:981-982. [PMID: 32437219 DOI: 10.1177/1753193420925012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Isidro Jiménez
- Department of Orthopaedic Surgery, Hospital Universitario Insular de Gran Canaria and Universidad de Las Palmas de Gran Canaria. Las Palmas de Gran Canaria, Spain
| | - Gustavo Muratore
- Department of Orthopaedic Surgery, Hospital Universitario Insular de Gran Canaria and Universidad de Las Palmas de Gran Canaria. Las Palmas de Gran Canaria, Spain
| | - Alberto Marcos-García
- Department of Orthopaedic Surgery, Hospital Universitario Insular de Gran Canaria and Universidad de Las Palmas de Gran Canaria. Las Palmas de Gran Canaria, Spain
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Jiménez I, Garcés G, Caballero-Martel J, Medina J. Dorsal web injection technique in the treatment of trigger finger and trigger thumb. Anatomical study. Rev Esp Cir Ortop Traumatol (Engl Ed) 2020. [DOI: 10.1016/j.recote.2020.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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13
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Jiménez I, Marcos-García A, Muratore G, Caballero-Martel J, Medina J. Denervation for Proximal Interphalangeal Joint Osteoarthritis. J Hand Surg Am 2020; 45:358.e1-358.e5. [PMID: 31477407 DOI: 10.1016/j.jhsa.2019.07.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 05/12/2019] [Accepted: 07/23/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE To assess the clinical and functional outcomes of proximal interphalangeal (PIP) joint denervation using a volar approach in the treatment of PIP joint osteoarthritis. METHODS We retrospectively reviewed 11 cases treated from June 2007 to June 2016. The patients were identified and outcomes collected through a single institution's registry, collecting demographic data, comorbidities, preoperative and postoperative visual analog scale (VAS) for pain, and Disorders of the Arm, Shoulder, and Hand (DASH) questionnaire. RESULTS The ring finger was the most commonly treated. The VAS for pain improved from 7.8 to 1.4, and the DASH questionnaire improved from 43.6 to 8.7. The PIP joint active range of motion also improved from 52° to 79°. Two patients reported postoperative digital paresthesia that resolved spontaneously. There were no major complications. CONCLUSIONS Proximal interphalangeal joint denervation is a safe technique. It achieves good clinical results and, in case of failure, a more traditional and aggressive operation remains possible. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic IV.
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Affiliation(s)
- Isidro Jiménez
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria. Las Palmas de Gran Canaria, Las Palmas, Spain.
| | - Alberto Marcos-García
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria. Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Gustavo Muratore
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria. Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Jonathan Caballero-Martel
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria. Las Palmas de Gran Canaria, Las Palmas, Spain
| | - José Medina
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria. Las Palmas de Gran Canaria, Las Palmas, Spain
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Jiménez I, Sánchez-Hernández J, Kiimetoglou D. Nonoperative Treatment of Ulnar Carpometacarpal Fracture-Dislocations. J Wrist Surg 2020; 9:160-163. [PMID: 32257619 PMCID: PMC7113011 DOI: 10.1055/s-0039-1688468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 03/25/2019] [Indexed: 10/26/2022]
Abstract
Background Ulnar carpometacarpal (CMC) joint dislocations and fracture-dislocations are uncommon injuries that are often overlooked. Most authors advocate surgical stabilization in order to prevent a secondary dislocation assuming that these injuries are inherently unstable. Case Description This is a series of eight ulnar CMC joint dislocations and fracture-dislocations treated by closed reduction and splint immobilization after assessing the joint stability. Mean follow-up was 30.2 months, and minimum follow-up was 12 months. Satisfactory results were obtained in range of motion, grip strength, pain, DASH (Disabilities of the Arm, Shoulder and Hand) questionnaire, and time to return to working activities. In the same period, the closed reduction and cast failed two (20%) cases that were referred for surgery. Literature Review There is little published literature on the nonoperative treatment of these injuries. Most of them are isolated case reports, whereas the largest series reports four cases. All of them have reported satisfactory results. Clinical Relevance Based on our results, we believe that if the diagnosis of an ulnar CMC joint dislocation or fracture-dislocation is early accomplished and a concentric and stable reduction is initially achieved, the nonoperative treatment may be a successful option to take into account but requiring a close follow-up for the first week.
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Affiliation(s)
- Isidro Jiménez
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Juan Sánchez-Hernández
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Dimosthenis Kiimetoglou
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
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Jiménez I, Garcés GL, Caballero-Martel J, Medina J. Dorsal web injection technique in the treatment of trigger finger and trigger thumb. Anatomical study. Rev Esp Cir Ortop Traumatol (Engl Ed) 2020; 64:355-360. [PMID: 32199767 DOI: 10.1016/j.recot.2020.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/04/2020] [Accepted: 02/07/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Corticosteroid injection is an effective treatment for trigger digits but the pain during the injection is an ever-present side effect. Since the palmar skin has a high density of sensitive receptors, injecting through dorsal skin could be less painful. Our aim was to assess whether a dorsal technique through the dorsal web is safe for extra-sheath injection of trigger fingers and thumb. MATERIAL AND METHOD This is an anatomical study in sixteen cadaveric hands. An injection through the dorsal web was performed on each digit. After careful resection of the palmar skin, the distance between the needle and the main anatomical structures was measured. The risk of major injury was considered high when the mean distance from the needle to the neurovascular bundle was below 1mm. RESULTS The mean distance from the needle to the neurovascular bundle was 1.77mm. Two neurovascular injuries in 112 injections were observed, one nerve and one artery. The safest digit was the thumb while the most dangerous was the index finger. At the ring finger, the technique was safer when it was carried out from the dorso-radial. CONCLUSIONS A subcutaneous injection near the flexor tendon sheath can be carried out through the dorsal web with a low, but present, risk of neurovascular injury. It could be useful for injection in the treatment of trigger finger and trigger thumb but it should be assessed in a clinical study.
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Affiliation(s)
- I Jiménez
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España; Departamento de Ciencias Médicas y Quirúrgicas, Facultad de Medicina, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España.
| | - G L Garcés
- Departamento de Ciencias Médicas y Quirúrgicas, Facultad de Medicina, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España; Departamento de Cirugía Ortopédica y Traumatología, Hospital Perpetuo Socorro, Las Palmas de Gran Canaria, España
| | - J Caballero-Martel
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España
| | - J Medina
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España; Departamento de Ciencias Médicas y Quirúrgicas, Facultad de Medicina, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España
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Jiménez I, Marcos-García A, Romero-Pérez B, Garcés-Martín G, Medina J. Effectivité et sécurité de l’injection à travers la peau dorsale dans le traitement du doigt et du pouce à ressaut: étude clinique prospective. Hand Surgery and Rehabilitation 2019. [DOI: 10.1016/j.hansur.2019.10.079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Chaparro M, Garre A, Guerra Veloz MF, Vázquez Morón JM, De Castro ML, Leo E, Rodriguez E, Carbajo AY, Riestra S, Jiménez I, Calvet X, Bujanda L, Rivero M, Gomollón F, Benítez JM, Bermejo F, Alcaide N, Gutiérrez A, Mañosa M, Iborra M, Lorente R, Rojas-Feria M, Barreiro-de Acosta M, Kolle L, Van Domselaar M, Amo V, Argüelles F, Ramírez E, Morell A, Bernardo D, Gisbert JP. Effectiveness and Safety of the Switch from Remicade® to CT-P13 in Patients with Inflammatory Bowel Disease. J Crohns Colitis 2019; 13:1380-1386. [PMID: 30976785 DOI: 10.1093/ecco-jcc/jjz070] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS To evaluate the clinical outcomes in patients with IBD after switching from Remicade® to CT-P13 in comparison with patients who maintain Remicade®. METHODS Patients under Remicade® who were in clinical remission with standard dosage at study entry were included. The 'switch cohort' [SC] comprised patients who made the switch from Remicade® to CT-P13, and the 'non-switch' cohort [NC] patients remained under Remicade®. RESULTS A total of 476 patients were included: 199 [42%] in the SC and 277 [58%] in the NC. The median follow-up was 18 months in the SC and 23 months in the NC [p < 0.01]. Twenty-four out of 277 patients relapsed in the NC; the incidence of relapse was 5% per patient-year. The cumulative incidence of relapse was 2% at 6 months and 10% at 24 months in this group. Thirty-eight out of 199 patients relapsed in the SC; the incidence rate of relapse was 14% per patient-year. The cumulative incidence of relapse was 5% at 6 months and 28% at 24 months. In the multivariate analysis, the switch to CT-P13 was associated with a higher risk of relapse (HR = 3.5, 95% confidence interval [CI] = 2-6). Thirteen percent of patients had adverse events in the NC, compared with 6% in the SC [p < 0.05]. CONCLUSIONS Switching from Remicade® to CT-P13 might be associated with a higher risk of clinical relapse, although this fact was not supported in our study by an increase in objective markers of inflammation. The nocebo effect might have influenced this result. Switching from Remicade® to CT-P13 was safe.
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Affiliation(s)
- M Chaparro
- Gastroenterology Units from Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa [IIS-IP] and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBERehd], Madrid, Spain
| | - A Garre
- Gastroenterology Units from Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa [IIS-IP] and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBERehd], Madrid, Spain
| | - M F Guerra Veloz
- Gastroenterology Units from Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - J M Vázquez Morón
- Gastroenterology Units from Hospital Juan Ramón Jiménez, Huelva, Spain
| | - M L De Castro
- Gastroenterology Units from Complejo Hospitalario Universitario de Vigo, Vigo, Spain
| | - E Leo
- Gastroenterology Units from Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - E Rodriguez
- Gastroenterology Units from Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - A Y Carbajo
- Gastroenterology Units from Hospital Universitario Río Hortega, Valladolid, Spain
| | - S Riestra
- Gastroenterology Units from Hospital Universitario Central de Asturias and ISPA, Asturias, Spain
| | - I Jiménez
- Gastroenterology Units from Hospital de Galdakao-Usansolo, Vizcaya, Spain
| | - X Calvet
- Gastroenterology Units from Consorcí Corporació Sanitària Parc Tauli de Sabadell and CIBERehd, Barcelona, Spain
| | - L Bujanda
- Gastroenterology Units from Instituto Biodonostia, Universidad del País Vasco [UPV/EHU] and CIBERehd, San Sebastián, Spain
| | - M Rivero
- Gastroenterology Units from Hospital Universitario Marqués de Valdecilla and IDIVAL, Santander, Spain
| | - F Gomollón
- Gastroenterology Units from Hospital Clínico Universitario Lozano Blesa, IIS Aragón and CIBERehd, Zaragoza, Spain
| | - J M Benítez
- Gastroenterology Units from Hospital Universitario Reina Sofía, Córdoba, Spain
| | - F Bermejo
- Gastroenterology Units from Hospital Universitario de Fuenlabrada and Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - N Alcaide
- Gastroenterology Units from Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - A Gutiérrez
- Gastroenterology Units from Hospital General Universitario de Alicante and CIBERehd, Alicante, Spain
| | - M Mañosa
- Gastroenterology Units from Hospital Germans Trials i Pujol and CIBERehd, Barcelona, Spain
| | - M Iborra
- Gastroenterology Units from Hospital Universitario y Politécnico de La Fe and CIBERehd, Valencia, Spain
| | - R Lorente
- Gastroenterology Units from Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - M Rojas-Feria
- Gastroenterology Units from Hospital Universitario Nuestra Señora de Valme, Sevilla, Spain
| | - M Barreiro-de Acosta
- Gastroenterology Units from Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
| | - L Kolle
- Gastroenterology Units from Hospital General de La Palma, La Palma, Spain
| | - M Van Domselaar
- Gastroenterology Units from Hospital Universitario de Torrejón, Madrid, Spain
| | - V Amo
- Gastroenterology Units from Hospital Regional Universitario de Málaga, Málaga, Spain
| | - F Argüelles
- Gastroenterology Units from Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - E Ramírez
- Gastroenterology Units from Pharmacy Unit, Hospital Universitario de La Princesa, IIS-IP, Madrid, Spain
| | - A Morell
- Gastroenterology Units from Pharmacy Unit, Hospital Universitario de La Princesa, IIS-IP, Madrid, Spain
| | - D Bernardo
- Gastroenterology Units from Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa [IIS-IP] and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBERehd], Madrid, Spain
| | - J P Gisbert
- Gastroenterology Units from Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa [IIS-IP] and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBERehd], Madrid, Spain
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Abstract
Pacinian corpuscles are rapidly adapting mechanoreceptors mainly distributed in the dermis of the fingers and palm of the hand. A neuroma of the Pacinian corpuscle is a rare and extremely painful condition with a few cases reported in the literature, most of them, associated with local or repetitive trauma. We present a 71-year-old man with history of pain and swelling on his left index without history of previous trauma initially diagnosed as tenosynovitis resistant to conservative treatment in which we observed, directly in the subcutaneous plane, spherical, gray and in clusters lesions closer to the collateral nerve which were described by the pathological study as neuroma of the Pacinian corpuscles.
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Affiliation(s)
- Isidro Jiménez
- 1 Unit of Hand, Upper Limb and Peripheral Nerve, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Alberto Marcos-García
- 1 Unit of Hand, Upper Limb and Peripheral Nerve, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Gustavo Muratore
- 1 Unit of Hand, Upper Limb and Peripheral Nerve, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - José Medina
- 1 Unit of Hand, Upper Limb and Peripheral Nerve, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
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Jiménez I, Carabia J, Bobillo S, Palacio C, Abrisqueta P, Nieto J, Castellví J, Martínez-Ricarte F, Escoda L, Perla C, Cespedes D, Boix J, Purroy N, Puigdefàbregas L, Seoane J, Bosch F, Crespo M. REVERSAL OF IMMUNE TOLERANCE AND INCREASED SURVIVAL AFTER XPO1 AND BTK INHIBITION IN MOUSE MODELS OF PRIMARY CNS LYMPHOMA (PCNSL). Hematol Oncol 2019. [DOI: 10.1002/hon.131_2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- I. Jiménez
- Laboratory of Experimental Hematology; Department of Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital (HUVH); Barcelona Spain
| | - J. Carabia
- Laboratory of Experimental Hematology; Department of Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital (HUVH); Barcelona Spain
| | - S. Bobillo
- Laboratory of Experimental Hematology; Department of Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital (HUVH); Barcelona Spain
| | - C. Palacio
- Laboratory of Experimental Hematology; Department of Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital (HUVH); Barcelona Spain
| | - P. Abrisqueta
- Laboratory of Experimental Hematology; Department of Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital (HUVH); Barcelona Spain
| | - J.C. Nieto
- Laboratory of Experimental Hematology; Department of Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital (HUVH); Barcelona Spain
| | - J. Castellví
- Department of Pathology; Vall d'Hebron University Hospital (HUVH), Universitat Autònoma de Barcelona; Barcelona Spain
| | - F. Martínez-Ricarte
- Department of Neurosurgery; Vall d'Hebron University Hospital (HUVH), Universitat Autònoma de Barcelona; Barcelona Spain
| | - L. Escoda
- Department of Hematology; Hospital Universitari Joan XIII; Tarragona Spain
| | - C. Perla
- Department of Neurosurgery; Hospital Universitari Joan XIII; Tarragona Spain
| | - D.H. Cespedes
- Department of Neurosurgery; Hospital Universitari Joan XIII; Tarragona Spain
| | - J. Boix
- Laboratory of Experimental Hematology; Department of Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital (HUVH); Barcelona Spain
| | - N. Purroy
- Laboratory of Experimental Hematology; Department of Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital (HUVH); Barcelona Spain
| | - L. Puigdefàbregas
- Laboratory of Experimental Hematology; Department of Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital (HUVH); Barcelona Spain
| | - J. Seoane
- Translational Research Program; Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital (HUVH), Universitat Autònoma de Barcelona, CIBERONC; Barcelona Spain
| | - F. Bosch
- Laboratory of Experimental Hematology; Department of Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital (HUVH); Barcelona Spain
| | - M. Crespo
- Laboratory of Experimental Hematology; Department of Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital (HUVH); Barcelona Spain
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Bermúdez-Triano M, Guerrero-Domínguez R, Martínez-Saniger A, Jiménez I. General anesthesia considerations in CADASIL disease. ACTA ACUST UNITED AC 2019; 66:226-229. [PMID: 30665799 DOI: 10.1016/j.redar.2018.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/29/2018] [Accepted: 10/31/2018] [Indexed: 10/27/2022]
Abstract
CADASIL (cerebral arteriopathy, autosomal dominant, with subcortical infarcts and leukoencephalopathy) disease is an inherited systemic arterial disease that affects the small and medium calibre cerebral vessels. Around 500 families are affected in the world, most of them in Europe. It is characterised by migraine attacks, subcortical dementia, neuropsychiatric disorders, and recurrent ischaemic strokes. The objective of this article is to describe, for the first time in the literature, the management by general anaesthesia of an intracranial neurosurgical procedure in a patient with CADASIL disease. Continuous monitoring of blood pressure is considered essential, as well as the maintenance of normocapnia and normothermia to avoid the development of new cerebrovascular accidents. This disease is relevant due to its anaesthetic implications and the few publications to date.
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Affiliation(s)
- M Bermúdez-Triano
- Servicio de Anestesiología y Reanimación, Hospital de Rehabilitación y Traumatología, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - R Guerrero-Domínguez
- Servicio de Anestesiología y Reanimación, Hospital de Rehabilitación y Traumatología, Hospital Universitario Virgen del Rocío, Sevilla, España.
| | - A Martínez-Saniger
- Servicio de Anestesiología y Reanimación, Hospital de Rehabilitación y Traumatología, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - I Jiménez
- Servicio de Anestesiología y Reanimación, Hospital de Rehabilitación y Traumatología, Hospital Universitario Virgen del Rocío, Sevilla, España
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Peña E, Gonzalez H, Rosales F, Jiménez I, Valenzuela M, Peña A, Pinelli A, Camou J, Avendaño L, Dávila J, Muhlia A, Castillo C. PSII-21 Fiber type characterization and meat quality of hair lambs supplemented with ferulic acid. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.166] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | - L Avendaño
- Universidad Autónoma de Baja California,Mexicali, Mexico
| | | | | | - C Castillo
- Instituto Tecnológico de Sonora,Obregon, Mexico
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Jiménez I, Marcos-García A, Muratore G, Medina J. Bilateral Nonsynchronous Pacinian Corpuscle Neuroma. J Hand Surg Am 2018; 43:1142.e1-1142.e4. [PMID: 29627280 DOI: 10.1016/j.jhsa.2018.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 01/25/2018] [Accepted: 03/07/2018] [Indexed: 02/02/2023]
Abstract
Pacinian corpuscles are rapidly adapting mechanoreceptors distributed in the dermis of the fingers and palm of the hand. A neuroma of the pacinian corpuscle is rare and extremely painful, with only a few cases reported in the literature. A 71-year-old man with pain and swelling on his left index finger, initially diagnosed as tenosynovitis resistant to nonsurgical treatment, was referred to our center. During surgery, a cluster of spherical, gray lesions close to the digital nerve was found and excised. The pathological diagnosis was neuroma of the pacinian corpuscles. Two years later, he reported the same clinical findings on his right index finger with no improvement after nonsurgical treatment. During surgery, the same lesions were found and also identified as pacinian corpuscle neuromas.
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Affiliation(s)
- Isidro Jiménez
- Unit of Hand and Upper Extremity Surgery, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, Spain.
| | - Alberto Marcos-García
- Unit of Hand and Upper Extremity Surgery, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Gustavo Muratore
- Unit of Hand and Upper Extremity Surgery, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, Spain
| | - José Medina
- Unit of Hand and Upper Extremity Surgery, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, Spain
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Sánchez-Hernández J, Jiménez I, Kiimetoglou D, Muratore G, Medina J, García AM. [Proximal humeral resurfacing. Whats today indication?]. Acta Ortop Mex 2018; 32:316-321. [PMID: 31184001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Data published in the literature about humeral resurfacing prostheses are not conclusive with good functional results but with large differences in the revision rate. The aim of our study was to evaluate the clinical and functional outcomes in patients operated at our center. MATERIAL AND METHODS Retrospective study of 19 cases in 18 patients. Follow-up of 31 (12-61) months. Surgery was indicated in cases of primary or secondary osteoarthritis. Demographic data, Constant scale, DASH questionnaire, complications and satisfaction were analyzed. Three patients were lost to follow-up due to death unrelated to surgery. RESULTS Mean age of 56 (25-80) years. Constant normalized of 73 (23-104) points. DASH questionnaire of 31 (7-84) points. Ninety four percent of the patients resumed their recreational activities and 81% sports activities. In seven cases, inferior conflict in the glenoid with varus implant was observed radiologically. There were five complications; a conservatively resolved capsulitis, three reinterventions due to symptomatic inferior glenoid usury and another to uncontrollable pain in a conservative way. Patients without rotator cuff lesion presented better scores on the functional questionnaires. All patients were satisfied with the symptomatic improvement over the previous situation and would be operated again if necessary. CONCLUSIONS The functional outcomes reported are similar to those previously published and, based on them, we believe that the resurfacing prosthesis is an option to be considered in cases of primary or secondary osteoarthritis when there is no rotator cuff injury, regardless of age.
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Affiliation(s)
- J Sánchez-Hernández
- Departamento de Cirugía Ortopédica y Traumatología. Hospital Universitario Insular de Gran Canaria. Las Palmas de Gran Canaria, España
| | - I Jiménez
- Departamento de Cirugía Ortopédica y Traumatología. Hospital Universitario Insular de Gran Canaria. Las Palmas de Gran Canaria, España
| | - D Kiimetoglou
- Departamento de Cirugía Ortopédica y Traumatología. Hospital Universitario Insular de Gran Canaria. Las Palmas de Gran Canaria, España
| | - G Muratore
- Departamento de Cirugía Ortopédica y Traumatología. Hospital Universitario Insular de Gran Canaria. Las Palmas de Gran Canaria, España
| | - J Medina
- Departamento de Cirugía Ortopédica y Traumatología. Hospital Universitario Insular de Gran Canaria. Las Palmas de Gran Canaria, España
| | - A M García
- Departamento de Cirugía Ortopédica y Traumatología. Hospital Universitario Insular de Gran Canaria. Las Palmas de Gran Canaria, España
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Jiménez I, Delgado PJ. The reverse Sauvé-Kapandji procedure for the treatment of (posttraumatic) proximal radioulnar synostosis. Eur J Orthop Surg Traumatol 2018. [DOI: 10.1007/s00590-018-2168-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Jiménez I, Marcos-García A, Muratore-Moreno G, Romero-Pérez B, Álvarez-León EE, Medina J. [Subacromial sodium hyaluronate injection for the treatment of chronic shoulder pain: A prospective series of eighty patients]. Acta Ortop Mex 2018; 32:70-75. [PMID: 30182551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Our purpose was to assess the effectiveness of hyaluronic acid infiltrations for chronic shoulder pain as an alternative to the non-surgical and surgical treatments that are currently available. MATERIAL AND METHODS This is a prospective study of 80 consecutive patients suffering from chronic shoulder pain followed for twelve months. Five subacromial hyaluronic acid injections on five consecutive weeks were administrated to all patients. RESULTS A significant improvement within the whole group after six months was observed. Constant score improved by 7.7 points, DASH questionnaire decreased by 5 points and Visual Analog Scale for pain decreased by 1.6 points. Patients with history of less than 24 months of pain responded better to treatment. Females responded better. Patients with decreased subacromial space or cuff tear in the MRI improved but patients diagnosed by the MRI of acromioclavicular osteoarthritis worsened in all scales assessed. DISCUSSION Subacromial hyaluronic acid injections are specially effective in patients with history of less than 24 months of pain, a decreased subacromial space or partial or total cuff tear but, in our experience, its result is not good in patients with acromioclavicular osteoarthritis.
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Affiliation(s)
- I Jiménez
- Departamento de Cirugía Ortopédica y Traumatología. Hospital Universitario Insular de Gran Canaria. España
| | - A Marcos-García
- Departamento de Cirugía Ortopédica y Traumatología. Hospital Universitario Insular de Gran Canaria. España
| | - G Muratore-Moreno
- Departamento de Cirugía Ortopédica y Traumatología. Hospital Universitario Insular de Gran Canaria. España
| | - B Romero-Pérez
- Departamento de Cirugía Ortopédica y Traumatología. Hospital Universitario Insular de Gran Canaria. España
| | - E E Álvarez-León
- Departamento de Medicina Preventiva. Hospital Universitario Insular de Gran Canaria. España
| | - J Medina
- Departamento de Cirugía Ortopédica y Traumatología. Hospital Universitario Insular de Gran Canaria. España
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Abstract
UNLABELLED Our purpose was to review the clinical usefulness of the scratch collapse test (SCT) in the diagnosis of proximal entrapment of the median nerve in the forearm. Eighteen consecutive cases were reviewed. The diagnosis was based on the patient's symptoms and signs. The SCT was positive in the affected forearm in all clinical assessments before surgery and it was negative in all after median nerve release. An anatomical reason for nerve compression was identified in all cases at operation. The SCT is a useful tool for the diagnosis of the proximal entrapment of the median nerve. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Isidro Jiménez
- Hand and Upper Extremity Surgery Unit, Hospital Universitario HM Montepríncipe, Boadilla del Monte, Madrid, Spain
| | - Pedro J Delgado
- Hand and Upper Extremity Surgery Unit, Hospital Universitario HM Montepríncipe, Boadilla del Monte, Madrid, Spain
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Jiménez I, Manguila F, Dury M. Hypothenar hammer syndrome. A case report. Rev Esp Cir Ortop Traumatol (Engl Ed) 2017. [DOI: 10.1016/j.recote.2017.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Abstract
BACKGROUND Axial carpal dislocations and fracture-dislocations remain difficult to understand and to treat. The outcome is directly related to the injury pattern and long-term results are not good in most cases. METHODS 39-year-old male admitted to our emergency department after his left hand was caught between 2 rollers for 10 minutes. He was diagnosed of an open axial carpal dislocation type B (perihamate peripisiform) and type E (peritrapezium) of Garcia-Elias. An extensive debridement, reduction of the carpometacarpal dislocations and stabilization with Kirschner wires was performed requiring a full thickness skin graft 14 days after the trauma. RESULTS At 4-year follow-up, he had 70° of wrist extension, and 78° of wrist flexion, grip strength of 65% compared to the healthy side and x-ray showed mild signs of osteoarthritis. He was satisfied and returned to the same job. CONCLUSIONS Axial carpal dislocations continue to be difficult injuries to address but also to classify. Since the prognosis depends on the injury pattern and other associated lesions, we believe that adding a type G which include the association of different patterns to the classification of Garcia-Elias could be useful not in changing the treatment but probably indicating a worse prognosis.
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Affiliation(s)
- Isidro Jiménez
- Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain,Isidro Jiménez, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Avenida Marítima del Sur s/n, Las Palmas de Gran Canaria, 35016 Las Palmas, Spain.
| | - Martine Dury
- SOS Main Strasbourg, Clinique des Diaconesses, Strasbourg, France
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Jiménez I, Delgado PJ, Kaempf de Oliveira R. The Zitelli Bilobed Flap on Skin Coverage After Mucous Cyst Excision: A Retrospective Cohort of 33 Cases. J Hand Surg Am 2017; 42:506-510. [PMID: 28434834 DOI: 10.1016/j.jhsa.2017.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 02/12/2017] [Accepted: 03/08/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE To study the time to wound healing and recurrence rate achieved in the treatment of distal interphalangeal joint mucous cysts using the Zitelli modified bilobed flap. METHODS We surgically treated 33 patients from January 2006 to June 2015. We assessed demographic data, comorbidities, location and size of the cyst, time to wound healing, and complications. RESULTS The most affected finger was the right middle finger. All flaps survived and wounds healed in 14 days on average. The mucous cyst recurred in 1 of 33 cases. There were no major complications. CONCLUSIONS The Zitelli bilobed flap can provide good-quality skin coverage over the distal interphalangeal joint in a short period. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic IV.
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Affiliation(s)
- Isidro Jiménez
- Hand and Upper Extremity Surgery Unit, Hospital Universitario HM Montepríncipe, Boadilla del Monte, Madrid, Spain
| | - Pedro J Delgado
- Hand and Upper Extremity Surgery Unit, Hospital Universitario HM Montepríncipe, Boadilla del Monte, Madrid, Spain.
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Abstract
Background: Management and indications for surgery in the tetraplegic patient are highly complex because of the substantial functional deficits that they present and their effect on their daily activity. Our purpose was to evaluate the functional outcome in tetraplegic patients who underwent biceps-to-triceps transfer surgery according to Zancolli's modified technique. Methods: This is a retrospective study of 6 biceps-to-triceps transfers using Zancolli's modified technique in 4 patients. Mean follow-up was 45 months. We evaluated each patient's DASH (Disabilities of the Arm, Shoulder and Hand) score before surgery and 12 months later. Results: In the 6 arms that underwent surgery, full and active elbow extension against gravity at 12 months after surgery was achieved. The mean DASH score was 73.2 preoperatively and 20.8 twelve months postoperatively. One complication occurred. One patient reported loss of elbow flexion preventing thigh lift for transfers. This was resolved with a program of rehabilitation and specific muscle strengthening Conclusions: Zancolli's modified technique is simple and effective, with few complications, whereby we can provide more autonomy for the tetraplegic patient.
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Affiliation(s)
- José Medina
- Unit of Hand, Upper Limb and Peripheral Nerve, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Alberto Marcos-García
- Unit of Hand, Upper Limb and Peripheral Nerve, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Isidro Jiménez
- Unit of Hand, Upper Limb and Peripheral Nerve, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain,Isidro Jiménez, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Avenida Marítima del Sur, s/n, Las Palmas de Gran Canaria, 35016 Las Palmas, Spain.
| | - Gustavo Muratore
- Unit of Hand, Upper Limb and Peripheral Nerve, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - José Luis Méndez-Suárez
- Unit of Spinal Cord Injury, Department of Rehabilitation, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
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Jiménez I, Manguila F, Dury M. Hypothenar hammer syndrome. A case report. Rev Esp Cir Ortop Traumatol (Engl Ed) 2016; 61:354-358. [PMID: 27843038 DOI: 10.1016/j.recot.2016.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 09/20/2016] [Accepted: 09/25/2016] [Indexed: 11/30/2022] Open
Abstract
Hypothenar hammer syndrome is an uncommon injury of the ulnar artery in its passage through Guyon's canal, and has been associated with repetitive trauma. Its diagnosis requires of a high level of suspicion and a careful clinical interview. The appropriate treatment is not well defined in the literature, ranging widely from medical treatment to reconstructive surgery. A clinical case is presented of a 52 year-old healthy male, who presented with numbness of his fourth and fifth fingers after a trauma at the hypothenar eminence. The Allen test highlighted an absence of vascularisation from the ulnar artery, thus suspecting an ulnar artery thrombosis, which was later confirmed by angio-MRI. The thrombosed segment was resected and a by-pass with a forearm vein was performed to reconstruct the distal arterial flow, presenting with a good functional outcome at 6months follow-up.
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Affiliation(s)
- I Jiménez
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España.
| | - F Manguila
- SOS Main Strasbourg Centre, Clinique des Diaconesses. Estrasburgo, Francia
| | - M Dury
- SOS Main Strasbourg Centre, Clinique des Diaconesses. Estrasburgo, Francia
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Jiménez I, Marcos-García A, Medina J, Muratore-Moreno G, Caballero-Martel J. [Bristow-Latarjet Technique for anterior glenohumeral instability]. Acta Ortop Mex 2016; 30:291-295. [PMID: 28549359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND In treatment of anterior shoulder instability, many surgical techniques have been described, all of them with advantages and disadvantages. Our goal is to study the half term results on patients that underwent open Bristow-Latarjet surgery considering the preoperative ISIS value. MATERIAL AND METHODS This is a retrospective study of 33 patients which underwent open Bristow-Latarjet surgery in our center between 2005 and 2012. Average age of 33.2 years and follow up of 75 months. Results were taken by Rowe and Constant scores, DASH questionnaire and we also recorded a subjective assessment of the result by each patient. RESULTS No recurrence was reported. No reoperations. Mean Rowe score was 74.6 points and mean Constant score was 70 points. In the disability questionnaire (DASH), the mean value was 22.9 points. The outcome assessment by the patients was positive in 78.8%. The migration of a screw occurred in one patient but he still asymptomatic. No other complication was identified. CONCLUSIONS The Bristow-Latarjet technique is a reliable technique, with few complications and with an excellent rate of recurrence in treatment of chronic shoulder instability as reported in literature; it should be used as primary surgery in some cases and the preoperative ISIS score is an excellent and simple guide to select correctly the surgical technique for each patient.
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Affiliation(s)
- I Jiménez
- Departamento de Cirugía Ortopédica y Traumatología. Hospital Universitario Insular de Gran Canaria. Las Palmas de Gran Canaria, España
| | - A Marcos-García
- Departamento de Cirugía Ortopédica y Traumatología. Hospital Universitario Insular de Gran Canaria. Las Palmas de Gran Canaria, España
| | - J Medina
- Departamento de Cirugía Ortopédica y Traumatología. Hospital Universitario Insular de Gran Canaria. Las Palmas de Gran Canaria, España
| | - G Muratore-Moreno
- Departamento de Cirugía Ortopédica y Traumatología. Hospital Universitario Insular de Gran Canaria. Las Palmas de Gran Canaria, España
| | - J Caballero-Martel
- Departamento de Cirugía Ortopédica y Traumatología. Hospital Universitario Insular de Gran Canaria. Las Palmas de Gran Canaria, España
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Jiménez I, Muratore-Moreno G, Marcos-García A, Medina J. Metacarpophalangeal joint stiffness. Still a challenge for the hand surgeon? Rev Esp Cir Ortop Traumatol (Engl Ed) 2016. [DOI: 10.1016/j.recote.2016.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Jiménez I, Marcos-García A, Muratore-Moreno G, Medina J. Four surgical tips in the treatment of epicondylitis. Rev Esp Cir Ortop Traumatol (Engl Ed) 2016. [DOI: 10.1016/j.recote.2015.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Guerrero-Domínguez R, González-González G, Rubio-Romero R, Federero-Martínez F, Jiménez I. [Anaesthetic management of excision of a cervical intraspinal tumor with intraoperative neurophysiologic monitoring in a pregnant woman at 29 weeks]. ACTA ACUST UNITED AC 2015; 63:297-300. [PMID: 26275733 DOI: 10.1016/j.redar.2015.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 06/30/2015] [Accepted: 07/08/2015] [Indexed: 11/28/2022]
Abstract
The intraoperative neurophysiological monitoring is a technique used to test and monitor nervous function. This technique has become essential in some neurosurgery interventions, since it avoids neurological injuries during surgery and reduces morbidity. The experience of intraoperative neurophysiological monitoring is limited in some clinical cases due to the low incidence of pregnant women undergoing a surgical procedure. A case is presented of a 29-weeks pregnant woman suffering from a cervical intraspinal tumour with intense pain, which required surgery. The collaboration of a multidisciplinary team composed of anaesthesiologists, neurosurgeons, neurophysiologists and obstetricians, the continuous monitoring of the foetus, the intraoperative neurophysiological monitoring, and maintaining the neurophysiological and utero-placental variables were crucial for the proper development of the surgery. According to our experience and the limited publications in the literature, no damaging effects of this technique were detected at maternal-foetal level. On the contrary, it brings important benefits during the surgery and for the final result.
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Affiliation(s)
- R Guerrero-Domínguez
- Facultativo Especialista en Anestesiología y Reanimación, Hospital de Rehabilitación y Traumatología, Hospitales Universitarios Virgen del Rocío, Sevilla, España.
| | - G González-González
- Facultativo Especialista en Anestesiología y Reanimación, Hospital de Rehabilitación y Traumatología, Hospitales Universitarios Virgen del Rocío, Sevilla, España
| | - R Rubio-Romero
- Facultativo Especialista en Anestesiología y Reanimación, Hospital de Rehabilitación y Traumatología, Hospitales Universitarios Virgen del Rocío, Sevilla, España
| | - F Federero-Martínez
- Facultativo Especialista en Anestesiología y Reanimación, Hospital de Rehabilitación y Traumatología, Hospitales Universitarios Virgen del Rocío, Sevilla, España
| | - I Jiménez
- Facultativo Especialista en Anestesiología y Reanimación, Hospital de Rehabilitación y Traumatología, Hospitales Universitarios Virgen del Rocío, Sevilla, España
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Jiménez I, Marcos-García A, Muratore-Moreno G, Medina J. [Four surgical tips in the treatment of epicondylitis]. Rev Esp Cir Ortop Traumatol (Engl Ed) 2015; 60:38-43. [PMID: 26187524 DOI: 10.1016/j.recot.2015.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 05/15/2015] [Accepted: 06/03/2015] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Lateral epicondylitis is a common injury in the population. Most patients improve with conservative treatment, but in a small percentage surgery is necessary. The aim of this study is to analyse the clinical results obtained by a «4 surgical tips» technique. MATERIALS AND METHOD This is a retrospective study of 35 operated elbows, with a mean follow-up of 5.3 years. In all cases epicondylar denervation, removal of the angiofibroblastic degeneration core, epicondylectomy, and release of posterior interosseous nerve, was performed. Each patient was evaluated using the Broberg and Morrey Rating System (BMRS), Mayo Elbow Performance Score (MEPS), Visual Analogue Scale (VAS), DASH questionnaire, and a survey of subjective assessment. RESULTS BMRS mean score was 97.2 points, with 95.71 points with the MEPS. The mean decrease in VAS was 8.12 points, and the mean score on the DASH was 1.68 points. The results were rated as excellent or very good by 94.3% of patients. There was one recurrence, which resolved with further surgery. Two neuropraxia of the posterior interosseous nerve occurred, which completely recovered in 10 weeks. CONCLUSIONS Using the «4 surgical tips» technique, clinical resolution of symptoms in 97.1% was achieved at the first operation. Therefore, it appears to be an effective, reproducible technique with few complications, in the surgical treatment of lateral epicondylitis resistant to conservative treatment.
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Affiliation(s)
- I Jiménez
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España.
| | - A Marcos-García
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España
| | - G Muratore-Moreno
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España
| | - J Medina
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España
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Guerrero-Domínguez R, Acebedo-Martínez E, López-Herrera-Rodríguez D, Jiménez I. [Reply to the letter on the article «Comment to the article: "Unintended intraoperative extubation in a patient with Treacher Collins syndrome: Usefullness of GlideScope videolaryngoscope"»]. Rev Esp Anestesiol Reanim 2015; 62:294-295. [PMID: 25530432 DOI: 10.1016/j.redar.2014.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 10/27/2014] [Indexed: 06/04/2023]
Affiliation(s)
- R Guerrero-Domínguez
- Servicio de Anestesiología y Reanimación, Hospitales, Universitarios Virgen del Rocío, Sevilla, España.
| | - E Acebedo-Martínez
- Servicio de Anestesiología y Reanimación, Hospitales, Universitarios Virgen del Rocío, Sevilla, España
| | - D López-Herrera-Rodríguez
- Servicio de Anestesiología y Reanimación, Hospitales, Universitarios Virgen del Rocío, Sevilla, España
| | - I Jiménez
- Servicio de Anestesiología y Reanimación, Hospitales, Universitarios Virgen del Rocío, Sevilla, España
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Guerrero-Domínguez R, Rubio-Romero R, González-González G, Jiménez I. [Perioperative considerations for performing a brain biopsy on a patient with subtype VV2 sporadic Creutzfeldt-Jakob disease]. ACTA ACUST UNITED AC 2014; 62:213-7. [PMID: 25146772 DOI: 10.1016/j.redar.2014.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 05/25/2014] [Accepted: 07/09/2014] [Indexed: 11/25/2022]
Abstract
Creutzfeldt-Jakob disease (CJD) is the most common transmissible spongiform encephalopathy. It is an infectious, progressive, degenerative neurological disorder, with a presumably long incubation period, but a rapid fatal course. CJD is transmitted by a proteinaceous infectious agent, or «prion». Because the prions are difficult to eradicate and are resistant to the currently used sterilization methods, special precautions must be taken with all surgical instruments. It is recommended the single-use equipment, destruction of contaminated equipment, decontamination of reusable instruments, use of protective clothing, and storing and quarantining surgical instruments. The single-use equipment and some tissues and body fluids from the patient with CJD are highly infectious and must be incinerated. We report a case of a patient who had undergone brain biopsy for suspected of CJD, being confirmed to have sporadic CJD. Specific preventive measures were taken to reduce the risk of transmission to healthcare workers.
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Affiliation(s)
- R Guerrero-Domínguez
- UGC Bloque Quirúrgico Hospital de Traumatología y Rehabilitación, Servicio de Anestesiología y Reanimación, Departamento de Neuroanestesia, Hospital Virgen del Rocío, Sevilla, España.
| | - R Rubio-Romero
- UGC Bloque Quirúrgico Hospital de Traumatología y Rehabilitación, Servicio de Anestesiología y Reanimación, Departamento de Neuroanestesia, Hospital Virgen del Rocío, Sevilla, España
| | - G González-González
- UGC Bloque Quirúrgico Hospital de Traumatología y Rehabilitación, Servicio de Anestesiología y Reanimación, Departamento de Neuroanestesia, Hospital Virgen del Rocío, Sevilla, España
| | - I Jiménez
- UGC Bloque Quirúrgico Hospital de Traumatología y Rehabilitación, Servicio de Anestesiología y Reanimación, Departamento de Neuroanestesia, Hospital Virgen del Rocío, Sevilla, España
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Caretti I, Jiménez I, Van Doorslaer S. Chemical changes in irradiated polypropylene studied by X-ray photoabsorption and advanced EPR/ENDOR spectroscopies. Eur Polym J 2014. [DOI: 10.1016/j.eurpolymj.2014.01.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Guerrero-Domínguez R, Acebedo-Martínez E, López-Herrera-Rodríguez D, Jiménez I. [Unintended intraoperative extubation in a patient with Treacher Collins syndrome: usefullness of GlideScope(®) videolaryngoscope]. ACTA ACUST UNITED AC 2014; 61:467-9. [PMID: 24439524 DOI: 10.1016/j.redar.2013.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 11/12/2013] [Accepted: 11/12/2013] [Indexed: 11/28/2022]
Affiliation(s)
- R Guerrero-Domínguez
- Servicio de Anestesiología y Reanimación, Hospitales Universitarios Virgen del Rocío, Sevilla, España.
| | - E Acebedo-Martínez
- Servicio de Anestesiología y Reanimación, Hospitales Universitarios Virgen del Rocío, Sevilla, España
| | - D López-Herrera-Rodríguez
- Servicio de Anestesiología y Reanimación, Hospitales Universitarios Virgen del Rocío, Sevilla, España
| | - I Jiménez
- Servicio de Anestesiología y Reanimación, Hospitales Universitarios Virgen del Rocío, Sevilla, España
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Vélez-Arredondo JE, Guerrero-Domínguez R, Lezama-Núñez L, Jiménez I. [Awake craniotomy for surgical resection of a recurrent astrocytoma located in an eloquent brain area in a case of bilingualism]. ACTA ACUST UNITED AC 2013; 61:349-51. [PMID: 24161517 DOI: 10.1016/j.redar.2013.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 07/24/2013] [Indexed: 10/26/2022]
Affiliation(s)
- J E Vélez-Arredondo
- Servicio de Anestesiología y Reanimación, Hospitales Universitarios Virgen del Rocío, Sevilla, España
| | - R Guerrero-Domínguez
- Servicio de Anestesiología y Reanimación, Departamento de Neuroanestesia, Hospital de Rehabilitación y Traumatología, Hospitales Universitarios Virgen del Rocío, Sevilla, España.
| | - L Lezama-Núñez
- Servicio de Anestesiología y Reanimación, Departamento de Neuroanestesia, Hospital de Rehabilitación y Traumatología, Hospitales Universitarios Virgen del Rocío, Sevilla, España
| | - I Jiménez
- Servicio de Anestesiología y Reanimación, Departamento de Neuroanestesia, Hospital de Rehabilitación y Traumatología, Hospitales Universitarios Virgen del Rocío, Sevilla, España
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Guerrero-Domínguez R, López-Herrera-Rodríguez D, Jiménez I. [Giant meningioma with supra and infratentorial components. Anesthetic implications]. ACTA ACUST UNITED AC 2013; 61:296-7. [PMID: 23796842 DOI: 10.1016/j.redar.2013.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 04/14/2013] [Accepted: 04/17/2013] [Indexed: 12/01/2022]
Affiliation(s)
- R Guerrero-Domínguez
- Unidad de Gestión Clínica de Anestesiología y Reanimación, Hospitales Universitarios Virgen del Rocío, Sevilla, España.
| | - D López-Herrera-Rodríguez
- Unidad de Gestión Clínica de Anestesiología y Reanimación, Hospitales Universitarios Virgen del Rocío, Sevilla, España
| | - I Jiménez
- Unidad de Gestión Clínica de Anestesiología y Reanimación, Departamento de Neuroanestesia, Hospital de Rehabilitación y Traumatología, Hospitales Universitarios Virgen del Rocío, Sevilla, España
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Rudomin P, Jiménez I, Chávez D. Differential presynaptic control of the synaptic effectiveness of cutaneous afferents evidenced by effects produced by acute nerve section. J Physiol 2013; 591:2629-45. [PMID: 23478136 PMCID: PMC3678047 DOI: 10.1113/jphysiol.2013.253351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 03/07/2013] [Indexed: 11/08/2022] Open
Abstract
In the anaesthetized cat, the acute section of the saphenous (Saph) and/or the superficial peroneal (SP) nerves was found to produce a long-lasting increase of the field potentials generated in the dorsal horn by stimulation of the medial branch of the sural (mSU) nerve. This facilitation was associated with changes in the level of the tonic primary afferent depolarization (PAD) of the mSU intraspinal terminals. The mSU afferent fibres projecting into Rexed's laminae III-IV were subjected to a tonic PAD that was reduced by the acute section of the SP and/or the Saph nerves. The mSU afferents projecting deeper into the dorsal horn (Rexed's laminae V-VI) were instead subjected to a tonic PAD that was increased after Saph and SP acute nerve section. A differential control of the synaptic effectiveness of the low-threshold cutaneous afferents according to their sites of termination within the dorsal horn is envisaged as a mechanism that allows selective processing of sensory information in response to tactile and nociceptive stimulation or during the execution of different motor tasks.
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Affiliation(s)
- P Rudomin
- Department of Physiology, Biophysics and Neurosciences, Centro de Investigación y de Estudios Avanzados, del Instituto Politécnico Nacional, Avenida Instituto Politécnico Nacional 2408, México DF 07360, México.
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Arrojo Alvarez E, Prada P, Méndez L, Fernández J, González H, Jiménez I. PO-195 BIOCHEMICAL RESULTS FOR HIGH RISK PROSTATE CANCER AFTER HIGH-DOSE-RATE BRACHYTHERAPY WITH EXTERNAL RADIOTHERAPY. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)72161-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Moriones I, Sánchez R, Fernández J, Jiménez I, Sadaba R, Gómez F. 336. Insuficiencia mitral y cirugía aórtica asociadas en la tercera edad. Cirugía Cardiovascular 2012. [DOI: 10.1016/s1134-0096(12)70418-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
A 70-year-old white man presented to the internal medicine outpatient clinic with symptoms of significant hyperhidrosis. He had been started on antiretroviral therapy (ART) with tenofovir, lamivudine and nevirapine. The patient complained of excessive sweating following severe asthenia after taking nevirapine. Based on these findings, we suspected that the causative agent was nevirapine and a diagnosis of hyperhidrosis due to nevirapine was made. Nevirapine treatment was stopped and was substituted with efavirenz: the patient continued on therapy with tenofovir and lamivudine. The hyperhidrosis symptoms resolved in 2-3 days. No relapse was observed with the new ART regimen. Drugs that induce hyperhidrosis can cause patient discomfort and embarrassment. In our patient, this adverse drug reaction also caused severe asthenia that decreased the patient's physical and emotional quality of life. There was a temporal relationship between the developments of symptoms and starting nevirapine therapy. Once nevirapine was suspended and switched to efavirenz, excessive sweating resolved. An objective causality assessment revealed that the adverse effect was probable. Until further data are available, clinicians should consider discontinuation of nevirapine therapy in patients who develop severe hyperhidrosis.
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Affiliation(s)
- A Belda
- Internal Medicine Service, Hospital de Sagunto, Valencia, Spain
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47
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Chávez D, Rodríguez E, Jiménez I, Rudomin P. Changes in correlation between spontaneous activity of dorsal horn neurones lead to differential recruitment of inhibitory pathways in the cat spinal cord. J Physiol 2012; 590:1563-84. [PMID: 22271870 DOI: 10.1113/jphysiol.2011.223271] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Simultaneous recordings of cord dorsum potentials along the lumbo-sacral spinal cord of the anaesthetized cat revealed the occurrence of spontaneous synchronous negative (n) and negative-positive (np) cord dorsum potentials (CDPs). The npCDPs, unlike the nCDPs, appeared preferentially associated with spontaneous negative dorsal root potentials (DRPs) resulting from primary afferent depolarization. Spontaneous npCDPs recorded in preparations with intact neuroaxis or after spinalization often showed a higher correlation than the nCDPs recorded from the same pair of segments. The acute section of the sural and superficial peroneal nerves further increased the correlation between paired sets of npCDPs and reduced the correlation between the nCDPs recorded from the same pair of segments. It is concluded that the spontaneous nCDPs and npCDPs are produced by the activation of interconnected sets of dorsal horn neurones located in Rexed's laminae III–IV and bilaterally distributed along the lumbo-sacral spinal cord. Under conditions of low synchronization in the activity of this network of neurones there would be a preferential activation of the intermediate nucleus interneurones mediating Ib non-reciprocal postsynaptic inhibition. Increased synchronization in the spontaneous activity of this ensemble of dorsal horn neurones would recruit the interneurones mediating primary afferent depolarization and presynaptic inhibition and, at the same time, reduce the activation of pathways mediating Ib postsynaptic inhibition. Central control of the synchronization in the spontaneous activity of dorsal horn neurones and its modulation by cutaneous inputs is envisaged as an effective mechanism for the selection of alternative inhibitory pathways during the execution of specific motor or sensory tasks.
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Affiliation(s)
- D Chávez
- Department of Physiology, Biophysics and Neurosciences, Centre for Research and Advanced Studies, National Polytechnic Institute, México DF, México
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48
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Abstract
The puerperium is the period from the end of labour to the appearance of the first menstruation. The possible pathologies that can occur in this period of time are the most frequent cause of maternal mortality even in our setting. The pathology of lactation includes failure of breastfeeding, cracks in the nipple, mammary ingurgitation and puerperal mastitis. Puerperal infection is a frequent obstetric complication although clinical guidelines for prophylaxis have considerably reduced its incidence. The vascular pathology of the puerperium includes clinical features of great seriousness, representing one of the main causes of maternal mortality. These include deep vein thrombosis, of which pulmonary thromboembolism is the most serious complication. It does not appear that a psychiatric pathology is more frequent in the puerperium than in other periods of life, but the clinical features related to this period are described, such as "blues", puerperal depression and puerperal psychosis. Finally, other clinical features which although infrequent can constitute a medical emergency in the puerperium are: Sheehan's syndrome, peripartum cardiomyopathy and postpartum thyroids.
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Affiliation(s)
- B Bezares
- Servicio de Obstetricia y Ginecología, Hospital Virgen del Camino, Pamplona, 31008, Spain.
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49
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Jiménez I, Sobrino T, Rodríguez-Yáñez M, Pouso M, Cristobo I, Sabucedo M, Blanco M, Castellanos M, Leira R, Castillo J. High serum levels of leptin are associated with post-stroke depression. Psychol Med 2009; 39:1201-1209. [PMID: 19356259 DOI: 10.1017/s0033291709005637] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Depression is a frequent mood disorder that affects around 33% of stroke patients and has been associated with both poorer outcome and increased mortality. Our aim was to test the possible association between inflammatory and neurotrophic molecular markers and the development of post-stroke depression. METHOD We studied 134 patients with a first episode of ischemic stroke without previous history of depression or speech disorders. We screened for the existence of major depression symptoms in accordance with DSM-IV criteria and a Yesavage Geriatric Depression Scale (GDS) score >11 at discharge and 1 month after stroke. At these times, serum levels of molecular markers of inflammation [interleukin (IL)-1beta, IL-6, intracellular adhesion molecule 1 (ICAM-1), tumor necrosis factor (TNF)-alpha, leptin and high-sensitivity C-reactive protein (hs-CRP)] and neurotrophic factors [brain-derived neurotrophic factor (BDNF)] were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS Twenty-five patients (18.7%) were diagnosed as having major depression at discharge. Out of 104 patients who completed the follow-up period, 23 were depressed at 1 month (22.1%). Patients with major depression showed higher serum leptin levels at discharge [43.4 (23.4-60.2) v. 6.4 (3.7-16.8) ng/ml, p<0.001] and at 1 month after stroke [46.2 (34.0-117.7) v. 6.4 (3.4-12.2) ng/ml, p<0.001). Serum levels of leptin >20.7 ng/ml were independently associated with post-stroke depression [odds ratio (OR) 16.4, 95% confidence interval (CI) 5.2-51.5, p<0.0001]. Leptin levels were even higher in the eight patients who developed depression after discharge [114.6 (87.6-120.2) v. 7.2 (3.6-13.6) ng/ml, p<0.0001]. CONCLUSIONS Serum leptin levels at discharge are found to be associated with post-stroke depression and may predict its development during the next month.
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Affiliation(s)
- I Jiménez
- Department of Neurology, Neuropsychology Laboratory, Clinical Neuroscience Research Laboratory, Hospital Clínico Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
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