Introduction: Carpal tunnel syndrome is a debilitating medical condition to many patients, and in cases refractory to conservative treatment, carpal tunnel decompressive surgery is indicated. In Latin America, however, little is known about the patient’s perception of the surgical procedure and their experience. Objective: In this study, we analyzed patient’s perception and the overall experience about carpal tunnel decompression in a Brazilian public institution and compared the results with literature from other countries. Methods: We conducted a prospective qualitative study with semi-structured interviews with 20 patients who underwent carpal tunnel release. Interviews were audio recorded and transcribed for thematic analysis. Results: Six topics emerged from the analysis: (1) functional restriction and pain are the main reason for seeking surgery; (2) our patients considered CTS as a serious illness, contrarily to previous reports of other countries. (3) patients were satisfied with the overall surgical experience; (4) many patients did not return to work after surgery, despite reporting significant improvement; (5) patients recommend surgical treatment as soon as possible; (6) most patients considered physical therapy important in rehabilitation. Conclusion: perception of CTS surgery is influenced by various socioeconomic and psychocultural variables, and further strategies to improve patient’s outcomes and expectations are still needed. In our community, we need to improve the perception of the severity of the disease and the recovering time before returning to work.
Background: French maritime pine bark (Pinus pinaster) extract (PBE), the registered trade name of which is Pycnogenol ® , has been studied for its depigmenting action due to its antioxidant, anti-inflammatory, and anti-melanogenic activity. However, the mechanisms through which PBE are still not fully clear.Objective: Evaluate the impact of PBE on four in vitro parameters closely associated with cutaneous pigmentation, including melanin synthesis, tyrosinase activity, endothelin-1 (ED1), and production of peroxisome proliferator-activated receptor α, δ, and γ (PPAR α, δ, and γ), by studying the modulation of action of ultraviolet radiation A (UVA)/ultraviolet radiation B (UVB), infrared-A (IR-A), visible light (VL), and association of UVA/UVB, IR-A, and VL (ASS).Methods: Human melanocytes were incubated in a dry extract solution of PBE, exposed to UVA/UVB, IR-A, VL, and ASS for subsequent quantification of melanin, ED1, and PPAR α, δ, and γ. The effects of PBE on inhibition of tyrosinase activity were also performed by monophenolase activity assay.Results: UVA/UVB, IR-A, VL, and ASS radiation caused significant increases in the synthesis of melanin, ED1, and PPAR α, δ, and γ when compared to baseline control.However, PBE significantly reduced the production of melanin, ED1, and PPAR α, δ, and γ, as well as reducing about 66.5% of the tyrosinase activity.Conclusions: PBE reduces in vitro melanin production by downregulating tyrosinase and reducing pigmentation-related mediators, such as ED1 and PPAR α, δ, and γ, therefore contributing to the inhibition of pathways associated with skin hyperpigmentation.
To compare the accuracy of three volumetric methods in the radiological assessment of meningiomas: linear (ABC/2), planimetric, and multiparametric machine learning-based semiautomated voxel-based morphometry (VBM), and to investigate the relevance of tumor shape in volumetric error. MethodsRetrospective imaging database analysis at the authors' institutions. We included patients with a con rmed diagnosis of meningioma and a volumetric acquired cranial magnetic resonance imaging.After tumor segmentation, images underwent automated computation of shape properties such as sphericity, roundness, atness, and elongation. ResultsSixty-nine patients (85 tumors) were included. Tumor volumes were signi cantly different using linear (13.82 cm³ [range: 0.13-163.74 cm³]), planimetric (11.66 cm³ [range: 0.17-196.2 cm³]) and VBM methods (10.24 cm³ [range: 0.17-190.32 cm³]) (p < 0.001). Median volume and percentage errors between the planimetric and linear methods and the VBM method were 1.08 cm³ and 11.61%, and 0.23 cm³ and 5.5%, respectively. Planimetry and linear methods overestimated the actual volume in 79% and 63% of the patients, respectively. Correlation studies showed excellent reliability and volumetric agreement between manual-and computer-based methods. Larger and atter tumors had greater accuracy on planimetry, whereas less rounded tumors contributed negatively to the accuracy of the linear method. ConclusionSemiautomated VBM volumetry for meningiomas is not in uenced by tumor shape properties, whereas planimetry and linear methods tend to overestimate tumor volume. Furthermore, it is necessary to consider tumor roundness prior to linear measurement so as to choose the most appropriate method for each patient on an individual basis. methods. VBM could replace manually-based volumetric assessment in the future, especially for research purposes, and could have a complementary role for clinical purposes.
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