3 research outputs found
Neurophysiological classification of the Carpal Tunnel Syndrome
The aim of this study was to evaluate the clinical correlation of the neurophysiological scale of the Carpal Tunnel Syndrome (CTS). The hands were classified in 6 grades: minimum/grade 1 (comparative test / altered short segment, normal sensitive and motor conductions), mild/grade 2 (altered sensitive conduction, normal motor conduction), moderate/grade 3 (altered sensitive and motor conductions, normal sensitive amplitude), moderate/grade 4 (altered sensitive and motor conductions, low sensitive amplitude), severe/grade 5 (absent sensitive conduction, altered motor conduction) and extremely severe/grade 6 (absent sensitive and motor conductions). A prospective study was carried out in 400 hands with CTS. 56 hands (14%) were classified as grade 1,109 hands (27.3%) as grade 2, 129 hands (32.3%) as grade 3, 78 hands (19.5%) as grade 4, 22 hands (5.5%) as grade 5 and 6 hands (1.5%) as grade 6. There was a significant positive correlation (p < 0.01) between the neurophysiological scale of CTS and the patientsâ ages, the duration of CTS, the frequency of reported classical CTS history and the frequency of night pain symptoms, paresthesia and numbness. Additionally, there was a significant positive correlation between the neurophysiological scale and the frequency of Tinel`s sign, hypoesthesia on the 2nd digit, weakness and hypotrophy of the thenar muscles.O objetivo deste trabalho foi avaliar a correlação clĂnica da escala neurofisiolĂłgica da SĂndrome do TĂșnel do Carpo (STC). As mĂŁos foram classificadas em 6 graus: mĂnimo/grau 1 (teste comparativo/segmento curto alterado, conduçÔes sensitiva e motora normais), leve/grau 2 (condução sensitiva alterada, condução motora normal), moderada/grau 3 (conduçÔes sensitiva e motora alteradas, amplitude sensitiva normal), moderada/grau 4 (conduçÔes sensitiva e motora alteradas, amplitude sensitiva baixa), grave/grau 5 (condução sensitiva ausente, condução motora alterada) e extremo/grau 6 (conduçÔes sensitiva e motora ausentes). Foi realizado um estudo prospectivo em 400 mĂŁos com STC. Foram classificadas 56 mĂŁos (14,0%) como grau 1, 109 mĂŁos (27,3%) como grau 2, 129 mĂŁos (32,3%) como grau 3, 78 mĂŁos (19,5%) como grau 4, 22 mĂŁos (5,5%) como grau 5 e 6 mĂŁos (1,5%) como grau 6. Houve uma correlação positiva significativa (p<0,01) da escala neurofisiolĂłgica da STC com a idade dos pacientes, o tempo de duração da STC, a freqĂŒĂȘncia de relato de histĂłria clĂĄssica de STC e a freqĂŒĂȘncia dos sintomas dor noturna, parestesia e dormĂȘncia. TambĂ©m houve uma correlação positiva significativa entre a freqĂŒĂȘncia do sinal de Tinel, hipoestesia no 2° dedo, fraqueza e hipotrofia dos mĂșsculos tenares com a escala neurofisiolĂłgica da STC
Comparative study of esketamine and racemic ketamine in treatment-resistant depression: Protocol for a non-inferiority clinical trial
Carvalho, Lucas Pedreira de. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. LaboratĂłrio de Pesquisa ClĂnica. Salvador, BA, Brasil. a Postgraduate Program in Medicine and Health, b Psychiatry Service, University Hospital, Universidade Federal da Bahia, Salvador, c LiNCâLaboratĂłrio Interdisciplinar
de NeurociĂȘncias ClĂnicas, d Depatment of Anesthesiology, e PRODAFâPrograma de Transtornos Afetivos, Universidade Federal de SĂŁo Paulo, SĂŁo Paulo,
f Postgraduate Program in Psychology, Institute of Psychology, g Immunology Service, Universidade Federal da Bahial, h Clinical Research Laboratory (LAPEC), Gonçalo
Moniz Institute, Fiocruz-Bahia, Salvador, Brazil, i McGill Group for Suicide Studies, Douglas Mental Health University Institute & Department of Psychiatry, McGill
University, Montreal, Canada, j Center for Research and Clinical Trials Sinapse-Bairral, Instituto Bairral de Psiquiatria, Itapira, Brazil.Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2018-12-21T16:28:46Z
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Previous issue date: 2018Allergan and Lundbeck and research fees from Janssen Pharmaceutical during the last 12 months. ALTL has received
consulting fees from Janssen Pharmaceutical, Daiichi Sankyo Brasil, Cristalia Produtos QuĂmicos e FarmacĂȘuticos, Libbs FarmacĂȘutica and SanofiAventis and has
received research fees from Eli Lilly, H. Lundbeck A/S, Servier Laboratories, Hoffman-La Roche and Forum Pharmaceuticals during the last 12 months.MĂșltipla - ver em NotasThe use of ketamine as an option in the treatment of depressive disorder is growing rapidly, supported by numerous clinical trials attesting its efficacy and safety. Esketamine, the S (+) enantiomer of ketamine, is the most widely used form in the anesthetic environment in some countries, and new studies have shown that it may also be effective in depression and with better tolerability. However, no study so far has directly compared esketamine with racemic ketamine. Here we propose a protocol of a clinical trial to evaluate esketamine as a noninferior medicationMethods/design: This study protocol is for a randomized, controlled, double-blind noninferiority clinical trial. Subjects will be 18
years or older, with major depression characterized as treatment-resistant. Participants will receive a single infusion of either
esketamine (0.25mg/kg) or ketamine (0.5 mg/kg) over 40 minutes. The primary outcome will be the difference in remission rates
between the 2 treatment arms at 24 and 72hours after drug infusion. Secondary outcomes will include other timepoints,
measurements of cognition, dissociation, and blood biomarkers.
Discussion: A head-to-head study is the best way to evaluate whether the esketamine is in fact comparable to the racemic
ketamine in terms of both efficacy and safety, and, if positive, it would be an initial step to increase the access to that type of treatment
worldwide.
Ethics and dissemination: The study was approved by the local Institutional Review Board (University Hospital Professor
Edgard SantosâFederal University of BahiaâNumber: 46657415.0.0000.0049). Subjects will only participate after voluntarily
agreeing and signing the Informed Consent Form. The study findings will be published in peer-reviewed journals and presented at
national and international conferences.
Trial registration: This trial has been registered in the Japan Primary Registries Network (JPRN): UMIN000032355, which is
affiliated with the World Health Organization. when compared to ketamine in the treatment of patients with treatment-resistant depression