Outcomes of bilateral carpal tunnel syndrome treatment - A systematic review and meta-analysis.

Carpal tunnel syndrome (CTS) is the predominant compressive neuropathy among adults worldwide. However, evidence regarding treatment alternatives and their outcomes, especially with bilateral carpus involvement, is inconclusive. To analyze the clinical and surgical outcomes of bilateral CTS treatment using the visual analog scale (VAS) and Boston questionnaire, a systematic review was conducted according to PRISMA guidelines. After evaluating 129 articles from different databases, nine papers with low bias risk were included in the study. These studies were assessed for methodological quality, both in scale and degree, ensuring bias identification and independence of data extraction. Eligible articles were those in Portuguese, Spanish, and English, with no publication time limit. The outcomes assessed were the standardized mean differences (SMDs) on the symptom severity scale (SSS), functional state scale (FSS), and VAS. In the clinical treatment group, a positive effect was observed on the SSS (SMD: 0.53), FSS (SMD: 0.47), and VAS (SMD decrease: 2.52) at the one-month follow-up. In the surgical-treatment group, a positive effect was observed on the SSS (SMDs: 1.97 for endoscopic and 1.55 for open surgery), FSS (SMDs: 1.52 for endoscopic and 1.77 for open surgery), and VAS (SMDs: 2.19 for endoscopic and 2.59 for open surgery) at the one-month follow-up. Significant improvements in VAS, SSS, and FSS were observed at the three-month follow-up. Current evidence in both clinical and surgical treatments demonstrates their effectiveness, as they potentially improve symptom severity, functional status, and pain intensity in patients with bilateral CTS during one- and three-month follow-up periods.

Decellularized Amniotic Membrane Scaffold as a Pericardial Substitute: An In Vivo Study.

BACKGROUND: In the development of new biomaterials for pericardium substitute, acellular amniotic membrane (AAM) presents potential for new applications in regenerative medicine. We studied an AAM as a pericardial substitute to achieve a suitable, cost effective, abundant matrix for the purpose of using it as graft for tissue repair. METHODS: Twenty Wistar rats were randomly divided into 2 groups (n = 10/group) and had their pericardiums excised. In the experimental group, the excised pericardium segment was substituted by a 7-mm-diameter patch of decellularized AAM sutured to the lesion area. After 4 weeks, the heart's outer layer of both groups was evaluated. The structure and component characteristics of the scaffold were determined with the use of hematoxylin and eosi, Alizarin Red S, and immumohistochemical staining and scanning electron microscopy. RESULTS: Histopathologic examination of the AAM patches revealed that the integrity of the AAM was preserved, and no calcification was observed on the surface of the myocardium. We also observed thicker pericardium repair tissue in the AAM group compared with the control group. AAM patches, by virtue of their low immunogenicity, evoked minimal host-versus-graft reaction. CONCLUSIONS: We conclude that AAM appears to be an ideal substitute for pericardium lesions, because it is integrated into the biologic tissue owing to its low immunogenicity and its ability to diminish the occurrence of adhesions and scarring, increasing the pericardium thickness.