The purpose of this study was to investigate the prevalence of migraine in medical students, as well as its clinical aspects and impact. All 595 medical students of Santa Casa School of Medicine of São Paulo, Brazil were asked if they had experienced any kind of headache in the past year. Those who responded positively were further investigated by an appropriate questionnaire. Diagnosis of migraine was based on the International Headache Society criteria of 1988. Forty percent of students suffered from some kind of headache; 40.2% of these headaches were migraine. The prevalence of migraine was 54.4% in women and 28.3% in men. Migraine headaches were unilateral in 24.2%, had a gradual onset in 69%, and were of a throbbing type in 88.3%. Migraine was considered incapacitating by 53.9% of students. Migraine with aura caused more disability than migraine without aura. Women experienced more intense migraine than men, and migraine with aura was especially more severe than migraine without aura. Photophobia, phonophobia, and nausea were more commonly encountered in migraine with aura. Despite the high prevalence, the high rate of disability, and the need for analgesic medication, only 7.1% of students with migraine had sought medical treatment.
Objective: To compare the functional results among patients undergoing tenotomy with or without tenodesis of the long head of the biceps associated with arthroscopic repair of rotator cuff injuries, with a minimum two-year follow-up. Method: This was a retrospective non-randomized trial with evidence level III, in which the medical files of 77 patients with lesions of the long head of the biceps were reviewed and clinically reassessed. Among these, 55 patients underwent tenotomy without tenodesis and 22 underwent tenotomy with tenodesis, with outpatient follow-up for at least two years. The age, dominant side, operated side, lesion size using the Gartsman classification, pre and postoperative range of motion, presence or absence of the Popeye sign, pain in the bicipital groove and assessments using the University of California at Los Angeles (UCLA) score and the elbow strength index. Results: The mean UCLA score of the sample went from 16.92 (range: 8 to 25) to 31.45 (range: 13 to 35) (p < 0.001). Comparison of the pre and postoperative UCLA scores in the two groups showed that the difference in the group with tenotomy and tenodesis was 15.95 and in the group with tenotomy alone, 14.62 (p = 0.023). However, there was no statistical significance in comparing the groups regarding pain in the bicipital groove, Popeye sign or elbow strength index. Conclusion: This study showed that the difference in UCLA scores was statistically significant. The group with tenotomy and tenodesis of the long head of the biceps presented better functional results.
The Bernageau radiographic view is an accurate and reproducible technique for measuring the presence of glenoid erosion, with similar results when compared to the 3D CT scan.
Objective: To evaluate the efficacy of suprascapular nerve block in combination with infusion of anesthetic into the subacromial space, compared with interscalene block. Methods: Forty-five patients with small or medium-sized isolated supraspinatus tendon lesions who underwent arthroscopic repair were prospectively and comparatively evaluated through random assignation to three groups of 15, each with a different combination of anesthetic methods. The efficacy of postoperative analgesia was measured using the visual analogue scale for pain and the analgesic, anti-inflammatory and opioid drug consumption. Inhalation anesthetic consumption during surgery was also compared between the groups. Results: The statistical analysis did not find any statistically significant differences among the groups regarding anesthetic consumption during surgery or postoperative analgesic efficacy during the first 48 hours. Conclusion: Suprascapular nerve block with infusion of anesthetic into the subacromial space is an excellent alternative to interscalene block, particularly in hospitals in which an electrical nerve stimulating device is unavailable.
Objectives
To assess the outcomes of the arthroscopic margin convergence of the posterior cuff to the biceps tendon
Methods
From October 2003 to December 2007, 20 patients with massive rotator cuff tear which include the rotator interval were treated with arthroscopic margin convergence of the posterior cuff to biceps tendon. Sixteen patients were female and four were male. The mean age was 58.95 years old. The dominant side was affected in 16 cases (80%). The outcomes were analysed according to the UCLA Score with a minimum follow-up period of two years.
Results
The UCLA score improved, on average, 14 points (p < 0.001). Six patients had excellent results; nine good; three fair and two poor results. The mean improvement of forward flexion was 33o (p < 0.001), 3o of external rotation (p < 0.396) and two vertebral levels for internal rotation (p < 0.025).
Conclusion
The arthroscopic margin convergence of the posterior cuff to the biceps tendon leads to satisfactory results.
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