El neuroma de la porción distal del nervio interóseo posterior como causa de dolor dorsal persistente de muñeca / Neuroma of the distal posterior interosseous nerve as a cause of persistent dorsal wrist pain

El dolor en el dorso de la muñeca es una causa frecuente de consulta médica en nuestra práctica clínica habitual. Normalmente este dolor puede ser debido a procesos traumáticos, inflamatorios o degenerativos. Pero en ocasiones el origen del dolor se aleja de estas causas frecuentes. Presentamos un caso de dolor crónico al nivel dorsal de muñeca sin claro antecedente traumático ni componente degenerativo o inflamatorio atribuible. Siendo de etiología neuropática, debido a un neuroma del nervio interóseo posterior precapsular. Se discuten posibles causas, métodos de diagnóstico y opciones de tratamiento (AU)

Dorsal wrist pain is a very common cause of complaint in the clinical practice of the hand surgeon. Such pain can frequently be related to traumatic, inflammatory or degenerative diseases, but sometimes its origin is far away from these common causes. A rare case is reported of chronic dorsal wrist pain of neuropathic origin, due to a pre-capsular neuroma of the posterior interosseous nerve. Possible causes, diagnostic hints, and treatment options are thoroughly discussed (AU)

Neuroma of the distal posterior interosseous nerve as a cause of persistent dorsal wrist pain. / El neuroma de la porción distal del nervio interóseo posterior como causa de dolor dorsal persistente de muñeca.

Dorsal wrist pain is a very common cause of complaint in the clinical practice of the hand surgeon. Such pain can frequently be related to traumatic, inflammatory or degenerative diseases, but sometimes its origin is far away from these common causes. A rare case is reported of chronic dorsal wrist pain of neuropathic origin, due to a pre-capsular neuroma of the posterior interosseous nerve. Possible causes, diagnostic hints, and treatment options are thoroughly discussed.

Treatment of distal biceps tendon rupture: why, when, how? Analysis of literature and our experience.

INTRODUCTION: The rupture of the distal biceps tendon is a relatively uncommon lesion. Even if conservative treatment may be an option in low demanding patients, young and active subjects may benefit from an early surgical reinsertion. Many techniques and fixation devices have been described, but in the literature, there are no clinical evidences that show the superiority of any of these. In this article, we report an analysis of the "state of the art" and our case series of surgical reinsertion with the double approach transosseous technique. MATERIALS AND METHODS: Between 2003 and 2013, 26 patients underwent surgical reinsertion, either for acute or for chronic lesions of distal biceps tendon. We evaluated 21 acute cases treated with double approach using DASH and SECEC Elbow Scores. The mean follow-up was 22 months. Range of motion, supination and flexion strength were also recorded. RESULTS: Mean final ROM was 6-132° in F/E and 89-0-87° in P/S; flexion and supination strength were 96 and 88 % compared to the opposite side. The main complications were two cases of heterotopic ossifications: one asymptomatic fracture of the proximal radius and one temporary neurapraxia of the radial nerve. CONCLUSIONS: Analysing the literature and our outcomes, we underline the importance of timing for surgery, in young and compliant patients, with a valid rehabilitation protocol for excellent results. The choice of surgical technique remains controversial, and we believe that the double approach transosseous reinsertion is a safe, costless and relatively non-invasive technique, offering satisfactory results when performed early.

Chemical modification of carbon nanomaterials (SWCNTs, DWCNTs, MWCNTs and SWCNHs) with diphenyl dichalcogenides.

Control over chemical functionalization is a crucial point in the field of nanotechnology. Herein, we present the covalent functionalization of several carbon nanoforms (single-walled carbon nanotubes, double-walled carbon nanotubes, multi-walled carbon nanotubes and carbon nanohorns) by means of diphenyl dichalcogenides. These ones show different reactivity to the nanomaterials and are able to modify their electronic properties depending on the electronegativity of the functionalizing heteroatom. Theoretical calculations were also performed to support the experimental results. All the modified structured nanocarbons were thoroughly characterized by TGA Raman, XPS, UV/Vis/nIR, IR and TEM techniques. Our findings propose a simple approach to functionalize carbon nanomaterials and, in the meantime, to tune their electronic properties.

Highly selective detection of Epinephrine at oxidized Single-Wall Carbon Nanohorns modified Screen Printed Electrodes (SPEs).

Oxidized Single-Wall Carbon Nanohorns (o-SWCNHs) were used, for the first time, to assemble chemically modified Screen Printed Electrodes (SPEs) selective towards the electrochemical detection of Epinephrine (Ep), in the presence of Serotonine-5-HT (S-5HT), Dopamine (DA), Nor-Epineprhine (Nor-Ep), Ascorbic Acid (AA), Acetaminophen (Ac) and Uric Acid (UA). The Ep neurotransmitter was detected by using Differential Pulse Voltammetry (DPV), in a wide linear range of concentration (2-2500 µM) with high sensitivity (55.77 A M(-1) cm(-2)), very good reproducibility (RSD% ranging from 2 to 10 for different SPEs), short response time for each measurement (only 2s) and low detection of limit (LOD=0.1 µM). o-SWCNHs resulted in higher analytical performances when compared with other nanomaterials used in literature for electrochemical sensors assembly.

Phase I trial of interleukin-2 and high-dose arginine butyrate in metastatic colorectal cancer.

INTRODUCTION: Interleukin-2 (IL-2) and sodium butyrate allow rats to be cured of peritoneal carcinomatosis from colon cancer. We performed a phase I trial of IL-2 and high-dose arginine butyrate (ArgB) in patients with advanced metastatic colorectal cancer. PATIENTS AND METHODS: From April to July 1997, six patients were included in the trail; they had a median age of 52 years, four had a performance status of 0, two had a performance status of 1 with normal biological functions. All patients had received at least two prior lines of chemotherapy. A fixed dose of 18 MIU/m2 IL-2,was administered by subcutaneous injection and ArgB was delivered via continuous intravenous infusion on days 1-6 with escalating doses starting at 2 g kg(-1) day(-1). RESULTS: The planned dose escalation was not possible because of toxicities. A daily ArgB dose of 2 g/kg was delivered for nine cycles. Level 2 (4 g/kg) could not be delivered in three of the six patients because of liver toxicity. The dose-limiting toxicities were fatigue and liver function disturbances. The maximum tolerated dose for ArgB was 3 g kg(-1) day(-1), in combination with IL-2 at 12 MIU m2 day(-1). No clinical response was seen. Pharmacokinetic analysis showed large intra- and interindividual variations. CONCLUSION: This schedule with a high dose of ArgB proved to be highly toxic with liver insufficiency. We will be running another trial with lower doses of ArgB calculated from the schedule used in the experimental model, starting at a dose of 20 mg kg(-1) day(-1) for ArgB and 200000 UI kg(-1) day(-1) IL-2, every 8 h.

Bispecific antibody and iodine-131-labeled bivalent hapten dosimetry in patients with medullary thyroid or small-cell lung cancer.

UNLABELLED: The purpose of this study was to estimate the dose delivered to tumor targets and normal tissues after two-step injection of an anti-CEA/anti-DTPA-In (F6-734) bispecific antibody and a 131I-labeled di-DTPA in-TL bivalent hapten in patients with medullary thyroid carcinoma (MTC) and small-cell lung cancer (SCLC). METHODS: Five patients with persistent disease or recurrences of MTC and five patients with primary SCLC or relapse were studied. In a first step, 0.1 to 0.3 mg/kg of F6-734 bispecific antibody was injected intravenously. Four days later, 6 nmole (5.8 to 9.8 mCi) of 131I-labeled di-DTPA in-TL bivalent hapten were injected. Quantitative imaging was performed during one week after the second injection. RESULTS: All 5 patients with MTC showed positive immunoscintigraphy (IS). In the smallest visualized and resected tumor (0.8 g), the fraction of injected activity per gram (% ID/g) was 0.1% at Day 3. IS was positive in 4 of the 5 patients with SCLC. The volume of the smallest visualized SCLC tumor was estimated at 11 +/- 2 ml, and tumor uptake was about 0.009% ID/g. Tumor dose estimates ranged from 4.2 to 174 cGy/mCi in patients with MTC and from 1.7 to 8 cGy/mCi in patients with SCLC. CONCLUSION: High absorbed dose values were calculated for small MTC recurrences. For SCLC recurrences the values were smaller but in the same range as those obtained by other investigators with the one-step technique in lymphoma.