Eficacia de la férula nocturna y el ultrasonido para tratar el síndrome del túnel carpiano. Estudio clínico controlado y aleatorizado

Objetivo: Comparar la eficacia de la inmovilización nocturna de la muñeca con una férula cubital en ángulo neutro junto con la aplicación de ultrasonido en pacientes con síndrome del túnel carpiano leve y moderado. Materiales y Métodos: Entre octubre de 2007 y marzo de 2010, se incluyó a pacientes >18 años con síndrome del túnel carpiano confirmado por electromiografía en un hospital de Buenos Aires. Se realizó una aleatorización estratificada, con bloques permutados aleatorios, y apareamiento por sexo y edad. Los pacientes fueron asignados al grupo experimental (GE) o al grupo de control (GC). Ambos grupos recibieron ultrasonido de 1 MHz pulsante por 15 min, 3 veces por semana, durante 6 semanas. Los pacientes del GE, además, utilizaron una férula nocturna. Se evaluaron el dolor y la parestesia con la escala analógica visual de 100 mm, la PSFS y el test de Moberg, al comenzar, a las 3 semanas y, al finalizar, a las 6 semanas, y durante el seguimiento, al mes, y a los 3 y 6 meses, con evaluador a ciego. Resultados: Se analizó a 32 pacientes del GC y a 33 del GE. Al finalizar el tratamiento, todas las variables habían mejorado en ambos grupos, con diferencia de medias estadísticamente significativa para el dolor a favor del GE a las 3 semanas de tratamiento 1,64 (IC95% 0,38-2,91; p = 0,012), pero sin diferencia clínica significativa. No se informaron efectos adversos. Conclusión: El tratamiento con una férula nocturna y ultrasonido no es superior al ultrasonido solo en pacientes con STC. Palabras clave: Síndrome del túnel carpiano; tratamiento; férulas; terapia con ultrasonido. Nivel de Evidencia: I

Teaching Design in Europe: Challenges and Trends

Design has recently gained much attention among practitioners and scholars as a source of innovation. Firms are increasingly investing in design and involving design firms in their innovation processes. This research is based on an ongoing research project that consists in a complete range of training courses focused on design and has the objective to discover how design-driven innovation can become the key to improve European SMEs competitiveness, efficiency and sustainability. In the meanwhile, focusing on the project data, the main aim of the paper is to take a picture of the trends at European level with respect to the main design phases, looking at the modules proposed by the course. Accordingly, this work will allow understanding which is the knowledge (in terms of design) most requested by European SMEs. In order to perform a first complete analysis, we focus on hierarchical cluster analysis (HCA), which is a statistical method able to build a hierarchy of clusters. The goal of the statistical analysis is to try to discover some hidden patterns existing in the dataset, which connect Modules and Countries, in order to understand if some specific relationships exist

Deactivation Model Study of High Temperature H2S Wet-Desulfurization by Using ZnO

High-temperature desulfurization techniques are fundamental for the development of reliable and efficient conversion systems of low-cost fuels and biomass that answer to the nowadays environmental and energy security issues. This is particularly true for biomass gasification coupled to SOFC systems where the sulfur content has to be minimized before being fed to the SOFC. Thus, commercially available zinc oxide has been studied and characterized as a desulfurizing agent in a fixed-bed reactor at high temperatures from 400 °C to 600 °C. The sorbent material was characterized by XRD, BET, SEM, and EDS analyses before and after adsorption. The sorbent’s sorption capacity has been evaluated at different temperatures, as well as the breakthrough curves. Moreover, the kinetic parameters as the initial sorption rate constant k0, the deactivation rate constant kd, and the activation energy have been calculated using the linearized deactivation model. The best performances have been obtained at 550 °C, obtaining a sorption capacity of 5.4 g per 100 g of sorbent and a breakthrough time of 2.7 h. These results can be used to extend ZnO desulfurization techniques to a higher temperature than the ones used today (i.e., 550 °C with respect to 400 °C)