Injection therapy for carpal tunnel syndrome: A systematic review and network meta-analysis of randomized controlled trials

Various injectants are available for the treatment of carpal tunnel syndrome. This systematic review and network meta-analysis was conducted to investigate the effectiveness of different injection therapies in alleviating the symptoms of carpal tunnel syndrome. Various databases were searched for relevant studies from inception until May 10, 2023. Eligible studies were identified using the patient (P), intervention (I), comparison (C), and outcomes (O) model, which involved (P) participants with carpal tunnel syndrome, (I) an intervention based on injection therapy, (C) the use of placebo or another injectant as a control treatment, and (O) the measurement of clinical and electrodiagnostic outcomes of interest. A total of 18 studies were included in the analysis. The network meta-analysis revealed that platelet-rich plasma is effective in the treatment of carpal tunnel syndrome in terms of symptom and pain relief and functional improvement in both the short and long term, whereas steroids are effective only in the short term. Additionally, injections of dextrose solution may offer long-term pain relief as well as short- and long-term symptom alleviation and functional improvement. The study findings suggest that platelet-rich plasma should be used as the first-line treatment for carpal tunnel syndrome, with dextrose and steroids serving as alternative treatment options.

Effects of 3D-printed assistive device on daily life function in patients with neurological impairment: a pilot study

PURPOSE

To explore the effects of customized 3D-printed assistive technology (AT) on functional performance and feasibility in patients with neurological impairment.

METHODS

Patients with neurological impairment were recruited and randomized into customized 3D-printed assistive device group (group 1; n = 17) or standard device group (group 2; n = 14). The device was designed to assist their writing, spoon using, and typing. Each patient underwent 4-week intervention with the device (30 min per session, twice a week).

RESULTS

We observed significant differences in shoulder abduction (p = .00), external rotation (p = .01), and internal rotation (p = .02) in group 1. And significant differences in abduction (p = .05) and external rotation (p = .05) between the 2 groups. Group 1 achieved significant improvements in writing without AT (p = .04) and with AT (p = .02), spoon use without AT (p = .02) and with AT (p = .03), and hemiplegia-side typing with AT (p = .00). Group 2 achieved significant improvements in writing without AT (p = .01), hemiplegia-side typing without AT (p = .01), and bil-side typing with AT (P = .05). Moreover, no significant differences were noted in other outcome measures.

CONCLUSIONS

This study demonstrated that customized 3D-printed AT can improve shoulder active motion for patients with neurological impairment. A positive effect in functional hand tasks after AT intervention. Offering customized AT with specific training could enhance the efficacy of interventions. The feasibility of using 3D printing technology to produce customized AT, which has the potential to be cost-effective and efficient.

Effects of a wearable sensor-based virtual reality game on upper-extremity function in patients with stroke

BACKGROUND

PABLO is a virtual reality game where a motion sensor system is used. Few studies have investigated the effects of the PABLO system in stroke rehabilitation. We investigated the effects of upper-extremity virtual reality training with the PABLO system in patients with stroke.

METHODS

Stroke patients were randomly assigned to the virtual reality (n = 19) or standard rehabilitation groups (n = 18). Total of 18 sessions were conducted twice per week. The primary outcome measure was the Fugl-Meyer Assessment-Upper Extremity subscale. Secondary outcome measures included the active ranges of motion of the shoulder and elbow, the box and block test, hand grip strength, and the Stroke Impact Scale. Enjoyment of activities and side effects were also recorded.

FINDINGS

No difference was observed between two groups in primary outcome. Virtual reality group exhibited greater improvements in the hand dexterity between groups (p = .05). In active motion, virtual reality group showed greater improvement in shoulder flexion between groups (p = .03). Virtual reality group also showed greater improvements in elbow pronation between groups (p = .03). The groups differed in their assessments of how enjoyment the rehabilitation activities were found (p = .01). No significant differences between groups were observed in any other tests.

INTERPRETATION

Interventions based on the PABLO virtual reality system improved upper extremity hand function, shoulder and elbow movements, and elicited a higher degree of enjoyment from study participants, than did traditional treatment.

TRIALS REGISTRATION

The study protocol was registered at ClinicalTrials.gov PRS (No.NCT04296032).

Electrical and optical properties of NiO composite films by radio frequency magnetron sputtering

The 100-nm NiO-Ag composite films with Ag content of 0 to 24.4 at.% are deposited on glass substrates. It is found that an ultra high electric resistivity (rho) value is obtained and cannot be detected by four point probe measurement when the Ag content is less than 3.4 at.%. The rho value is reduced significantly to 29.0 Omega-cm as Ag content is increased to 4.2 at.%, and it decreases greatly to 0.009 Omega-cm as the content of Ag is further increased to 24.4 at.%. The NiO-Ag composite film with Ag content of 4.2 at.% shows p-type conduction. However, it becomes n-type when the Ag content increases to 9.3 at.%, which results from the Ag atoms segregated at grain boundary of NiO when the excess Ag atoms are added into NiO films. On the other hand, the transmittance of the NiO-Ag films drops continuously from 96.3% to 31.6% as the Ag content increases from 0 to 24.4%.

Combined immersion and oral vaccination of Vietnamese catfish (Pangasianodon hypophthalmus) confers protection against mortality caused by Edwardsiella ictaluri

Edwardsiella ictaluri septicemia occurs worldwide and causes high mortality and considerable economic damage to the catfish industry especially in Vietnam and the USA. To control Edwardsiella septicemia farmers extensively use antibiotics and various vaccination methods. Vaccination with inactivated vaccines has come with variable efficacy. In this trial the results of an approach of controlling Edwardsiella septicemia of Tra catfish (Pangasianodon hypophthalmus) in Vietnam through vaccination via mucosal surfaces are presented. The results show that a combination of primary vaccination by immersion with inactivated E. ictaluri followed by an oral boost with a formulated antigen preparation induces a statistically significant level of protection against mortality caused by experimental infection 4 weeks post-boost. Fish immunized by immersion only show significantly lower level of protection but significantly higher than the controls. Repeated boosts result in improved duration of immunity with a relative percent survival (RPS) of 47% at 90% control mortality. The immunization procedure provides an alternative for disease control through vaccination.

Comparison of human, primate, and canine femora: implications for biomaterials testing in total hip replacement

The canine model remains an animal of choice for determining the efficacy and safety of various materials and designs used in human total hip replacement (THR). The primate also is used in orthopedic-related research for studying limb anatomy, gait, and age-related bone loss. In order to better understand the appropriateness of these animal models for human THR, external morphologies of thirty-three adult Caucasian human, sixteen adult chimpanzee, and forty-two adult greyhound femora were compared using osteometric methods. Measured parameters included anteversion angle, cervico-diaphyseal angle, femoral head offset in the frontal plane, and anterior bow profiles along the femoral diaphysis. Although some of the measured parameters were approximately similar between species (e.g., mean cervico-diaphyseal angle of humans and chimpanzees), the majority demonstrated morphologic differences that may be biomechanically significant for interpreting stress transfer across the hip (e.g., mean anteversion angle and mean normalized femoral head offset between species). Additionally, age-related changes in proximal femoral morphology and gait pattern, as well as species-related differences in local muscle and inertial forces, may result in notably different loading conditions across the hip joint of each species. Therefore, discretion must be exercised when evaluating canine or primate THR materials and designs for potential use in the human hip.

p(42)Be neutron therapy beams: dose rate and penetration as a function of target thickness and beam filtration

It is shown that, in the production of p(42)Be neutron beams for clinical use, the use of semithick targets leads to more desirable beam characteristics when appropriate backstop materials are used. Furthermore, an algebraic representation of beam penetration and of dose per unit charge on target, including hardening by polyethylene filters, provides a method for target optimization.

The influence of target thickness and backstop material on proton-produced neutron beams for radiotherapy

Results are presented of measurements of skin sparing, penetration and total dose per unit of incident charge for various target thicknesses and filtrations for a neutron beam generated by 42 MeV protons on beryllium. These results are contrasted to predictions outlined in a previous paper. The differences from these predictions are attributed to the contribution of low-energy neutrons produced by the residual proton beam in the thick copper target backstop.

Dosimetric measurements in the neutron field produced by a deuterium gas target with a compact medical cyclotron

Several dosimetric measurements have been carried out in the neutron field produced by accelerated deuterons incident upon a pressurized deuterium gas target. A significant improvement has been achieved in central-axis depth dose when compared to the 9Be(3He,n)11C interaction previously studied . Designs for a target with a high-power dissipation capability are currently underway.