Comparative study between physical examination, electroneuromyography and ultrasonography in diagnosing carpal tunnel syndrome

AbstractObjectiveTo evaluate the sensitivity of electromyography and ultrasonography in diagnosing carpal tunnel syndrome (CTS), in comparison with physical examination, which is considered to be the gold standard.MethodsIn this cross-sectional study, the medical files of 56 patients with 70 hands affected by CTS who were attended between March 2010 and June 2012 were reviewed. The study included patients with a clinical diagnosis of CTS. The sensitivity of the complementary examinations was analyzed and compared with physical examination.ResultsNocturnal symptoms were found in 96.4%, thenar atrophy in 62.5% and abnormal sense of touch in 50%. The sensitivities found were: ultrasonography, 67.1% (95% CI: 55.7%–78.6%); an association of physical examination tests, 95.7% (95% CI: 90.0%–100%); and electromyography, 98.6% (95% CI: 95.7%–100%). The presence of atrophy, abnormalities of the sense of touch and longer-duration symptoms increased the sensitivity of ultrasonography and physical examination.ConclusionThe sensitivity of ultrasonography for CTS was lower than that of electromyography and physical examination

Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences

The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on 18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based researchers who signed it in the short time span from 20 September to 6 October 2016

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

EFEITO INDIRETO DA TENS SOBRE OS MÚSCULOS CERVICAIS EM PORTADORES DE DTM

O objetivo do presente estudo foi identificar o efeito indireto da TENS sobre a dor e a atividade eletromiográfica (EMG) dos músculos esternocleidomastoideos (ECM) e trapézio fibras superiores (TRAP) em indivíduos portadores de Disfunção Temporomandibular (DTM). Para tal, foram selecionadas 12 mulheres, entre 19 e 40 anos (24,3±6,1), portadoras de DTM, diagnosticadas por meio dos Critérios de Diagnóstico para Pesquisa em Desordens Temporomandibulares (RDC). A TENS (pulso quadrado bifásico simétrico, 10 Hz, 200 ms, intensidade limiar motor e modulação em freqüência-50%) foi aplicada uma vez, por 30 minutos, sobre a face. O exame EMG, colhido por meio de um sistema de aquisição de sinais (Miosystem I®), com eletrodos de superfície diferenciais simples (Lynx®), foi realizado antes e após a aplicação da TENS. Foi realizada a linha de base do sinal EMG (3 coletas em 3 dias alternados, numa mesma semana, sempre no mesmo período). Para avaliação da dor, foi utilizada a escala visual analógica (EVA) aplicada antes e após aplicação da TENS. O sinal EMG foi normalizado, tendo como valor de referência o valor de RMS médio da linha de base do sinal EMG. Os testes para dados pareados foram aplicados após o procedimento de normalização. Observou-se aumento significativo do sinal EMG apenas para o músculo ECM esquerdo, quando o músculo trapézio realizou contração isométrica após a aplicação da TENS. Os demais músculos não apresentaram alterações significativas do sinal EMG. A TENS é eficaz para o alívio da dor em pacientes com DTM e promove efeitos além do local da estimulação

Estudo comparativo entre o exame físico, a eletroneuromiografia e a ultrassonografia no diagnóstico da síndrome do túnel do carpo

ResumoObjetivoAvaliar a sensibilidade da eletroneuromiografia (ENMG) e da ultrassonografia (USN) no diagnóstico de síndrome do túnel do carpo (STC) comparada com a do exame físico, considerado padrão‐ouro.MétodosEstudo seccional pela análise de prontuários de 56 pacientes com 70 mãos acometidas com STC entre março de 2010 e junho de 2012. A sensibilidade dos exames complementares foi analisada e comparada com a do exame físico.ResultadosConstataram‐se sintomas noturnos em 96,4%, hipotrofia tenar em 62,5% e alteração do tato em 50%. A sensibilidade da USG foi de 67,1% (95% IC, 55,7%‐78,6%); a da associação dos testes do exame físico, de 95,7 (95% IC, 90,0%‐100%); e a da ENMG, de 98,6% (95% IC, 95,7%‐100%). A presença de hipotrofia, de alterações no tato e o maior tempo dos sintomas aumentaram a sensibilidade da USG e do exame físico.ConclusãoA sensibilidade da USG para a STC foi inferior à da ENMG e à do exame físico.AbstractObjectiveTo evaluate the sensitivity of electromyography and ultrasonography in diagnosing carpal tunnel syndrome (CTS), in comparison with physical examination, which is considered to be the gold standard.MethodsIn this cross‐sectional study, the medical files of 56 patients with 70 hands affected by CTS who were attended between March 2010 and June 2012 were reviewed. The study included patients with a clinical diagnosis of CTS. The sensitivity of the complementary examinations was analyzed and compared with physical examination.ResultsNocturnal symptoms were found in 96.4%, thenar atrophy in 62.5% and abnormal sense of touch in 50%. The sensitivities found were: ultrasonography, 67.1% (95% CI: 55.7 to 78.6%); an association of physical examination tests, 95.7% (95% CI: 90.0 to 100%); and electromyography, 98.6% (95% CI: 95.7 to 100%). The presence of atrophy, abnormalities of the sense of touch and longer‐duration symptoms increased the sensitivity of ultrasonography and physical examination.ConclusionThe sensitivity of ultrasonography for CTS was lower than that of electromyography and physical examination