Analyzing the functional effects of dynamic and static splints after radial nerve injury.

The radial nerve is a commonly injured upper extremity peripheral nerve. The inability to extend the wrist results in a loss of hand function and dexterity that affects patients' ability to perform their activities of daily living. There is no strong evidence to support a particular splint design for improving dexterity. This cohort study compared whether a static or dynamic splint can improve hand dexterity when assessed with the 9-hole peg test (9-HPT) after radial nerve injury. Thirty-four subjects with radial nerve palsy participated in the study. The test was repeated three times for each subject, first without the splint, and then while wearing the control static wrist splint, and finally while wearing the dynamic splint. The 9-HPT was used as the outcome measure. The 9-HPT times were 36.4±4.8seconds without a wrist splint and improved when using the static and the dynamic splints to 33.5±4.5seconds (P<0.01) and 25.7±3.5seconds (P<0.01) respectively. The use of a dynamic splint after radial nerve palsy can provide the patient with greater manual dexterity when compared to using no splint or a static splint.

Seguimiento de mujeres con síndrome de Turner tratadas con hormona de crecimiento en la infancia y que han alcanzado la talla final / Follow-up of women with Turner syndrome treated with growth hormone in childhood and who have reached final height

INTRODUCCIÓN: El síndrome de Turner es un trastorno genético que se caracteriza por la monosomía total o parcial del cromosoma X. La talla baja puede ser la única manifestación de este síndrome, siendo actualmente una de las indicaciones de tratamiento con hormona de crecimiento. El objetivo de este trabajo ha sido realizar un estudio retrospectivo de pacientes con síndrome de Turner tratadas con hormona de crecimiento, con la finalidad de determinar qué variables se relacionan con una buena respuesta al tratamiento. MATERIAL Y MÉTODOS: Estudio de cohortes retrospectivo. Se incluyen 48 pacientes afectas de síndrome de Turner que recibieron tratamiento con hormona de crecimiento en la infancia y que han alcanzado talla final. Se realizó una regresión lineal múltiple para correlacionar qué variables independientes se correlacionan con la variable de resultado principal. RESULTADOS: Se observó una ganancia de talla de 0,56 ± 0,86 DS, siendo la talla final alcanzada de 149,2 ± 6,47 cm (-2,43 ± 1,14 DE). La mayor ganancia de talla se produjo durante el primer año de tratamiento. Los factores asociados, de manera estadísticamente significativa, con una mejor respuesta al tratamiento fueron la edad al inicio del mismo y la edad ósea al inicio del tratamiento estrogénico. CONCLUSIONES: Nuestro trabajo refleja una ganancia media de talla de 0,5 DE en mujeres con síndrome de Turner tratadas con hormona de crecimiento. Los factores implicados en una mayor ganancia de talla en nuestra serie son la edad de inicio del tratamiento con rhGH y la edad ósea al inicio del tratamiento con estrógenos

INTRODUCTION: Turner syndrome is a genetic disorder characterized by the total or partial monosomy of the X chromosome. Short stature may be the only manifestation of this syndrome, being currently one of the initiations of growth hormone treatment. The objective of this work has been carried out in a retrospective study of patients with Turner syndrome treated with growth hormone, with the determination to determine which variables are related to a good response to treatment. MATERIAL AND METHODS: Retrospective cohort study. It includes 48 patients affected by Turner syndrome who received treatment with childhood growth hormone and who have obtained final size. A multiple linear regression was performed to correlate which independent variables correlate with the main outcome variable. RESULTS: A size gain of 0.56 ± 0.86 SD was obtained, the final size being reached of 149.2 ± 6.47 cm (-2.43 ± 1.14 DS). The greatest height gain occurred during the first year of treatment. The associated factors, in a statistically significant way, with a better response to the treatment were the age at the beginning of the treatment and the bone age at the beginning of the estrogenic treatment. CONCLUSIONS: Our work reflects an average height gain of 0.5 SD in women with Turner syndrome treated with growth hormone. The factors involved in a greater height gain in our series are the age of onset of rhGH treatment and the age at the beginning of estrogen treatment

The hominid thumb and its influence on the employment during evolution.

Not available.

Clinical experience with integrase inhibitors in HIV-2-infected individuals in Spain.

BACKGROUND: HIV-2 is a neglected virus despite estimates of 1-2 million people being infected worldwide. The virus is naturally resistant to some antiretrovirals used to treat HIV-1 and therapeutic options are limited for patients with HIV-2. METHODS: In this retrospective observational study, we analysed all HIV-2-infected individuals treated with integrase strand transfer inhibitors (INSTIs) recorded in the Spanish HIV-2 cohort. Demographics, treatment modalities, laboratory values, quantitative HIV-2 RNA and CD4 counts as well as drug resistance were analysed. RESULTS: From a total of 354 HIV-2-infected patients recruited by the Spanish HIV-2 cohort as of December 2017, INSTIs had been given to 44, in 18 as first-line therapy and in 26 after failing other antiretroviral regimens. After a median follow-up of 13 months of INSTI-based therapy, undetectable viraemia for HIV-2 was achieved in 89% of treatment-naive and in 65.4% of treatment-experienced patients. In parallel, CD4 gains were 82 and 126 cells/mm3, respectively. Treatment failure occurred in 15 patients, 2 being treatment-naive and 13 treatment-experienced. INSTI resistance changes were recognized in 12 patients: N155H (5), Q148H/R (3), Y143C/G (3) and R263K (1). CONCLUSIONS: Combinations based on INSTIs are effective and safe treatment options for HIV-2-infected individuals. However, resistance mutations to INSTIs are selected frequently in failing patients, reducing the already limited treatment options.

Intrahippocampal administration of 5-HT6 receptor drugs on memory consolidation and amnesia protocols.

To our knowledge the intrahippocampal serotonergic 5-HT6 receptor tone on memory and amnesia models remains unexplored. Hence, in the present work we tested intrahippocampal administration of serotonin or 5-hydroxytryptamine (5-HT)6 receptor experimental molecules with differential intrinsic activity. Methods: In the present study, Automatized Autoshaping memory task was used, useful measuring memory, neural markers, and pharmacological effects. We are hypothesizing that experimental molecules with differential intrinsic activity might reveal serotonergic tone. Particularly, intrahippocampal administration of 5-HT6 receptor compounds with differential intrinsic activity (i.e., agonistic and antagonistic) might evidencing a serotonergic tone via this receptor. Bilateral intrahippocampal dose-response curves show that administration of EMD386088 (10 and 100 µg) had no effect or (50 µg) decreased conditioned responses (CR) in short- and long-term memory (STM and LTM, respectively); while SB-399885 (10 or 100 µg) significantly decreased CR in STM and LTM (24 and 48-h) or (50 µg) had no effect; thus suggesting that there is a 5-HT6 receptor tone regulating both STM and LTM. Moreover, intrahippocampal inactive doses of EMD386088 (5 µg) plus SB-399885 (0.5 µg) did not affect STM and LTM; however, partially or completely prevented the scopolamine or dizocilpine-induced amnesia. Thus confirming that both drugs exerted their effects through 5-HT6 receptor and that there is a hippocampal serotonergic tone under amnesic states, similar to that striatal.

Criptococosis cerebral, voriconazol, niveles plasmáticos y síndrome de reconstitución inmune: reporte de un caso / Cerebral cryptococcosis and immune reconstitution inflammatory syndrome: case report

We report a 45-year-old male with AIDS who had a Cryptococcus neoformans central nervous system infection. He was treated with amphotericin B deoxycholate subsequently changed to voriconazole due to systemic toxicity of the former. Plasma levels of voriconazole were insufficient with a standard dose (0.7 μg/mL), therefore, the dose was increased thereafter to reach appropriate levels (4.5 μg/mL). Anti-retroviral therapy was started five weeks after voriconazole initiation with non-interacting drugs and he was discharged after a favorable evolution. He was re-admitted three months later due to seizures; a brain magnetic resonance showed new sub-cortical nodules. After excluding alternative causes and demonstrating fungal eradication, an immune reconstitution inflammatory syndrome (IRIS) event was suspected and treated with a short course of steroids. His evolution was satisfactory.

TCNQ molecular semiconductor of the Cu(II)TAAB macrocycle: Optical and electrical properties.

The present study reports the doping of a semiconducting molecular material through the formation of hydrogen bonds between the macrocycle Cu(II)(TAAB) and the electronic acceptor TCNQ. According to density functional theory (DFT) calculations and electron paramagnetic resonance (EPR) analysis, the doped compound has the shape of a distorted square pyramid, with four nitrogen atoms in the equatorial position and the apical oxygen atom from the water ligands. These water molecules can generate strong hydrogen bonds with TCNQ and the TAAB metallic complex. Thin films of copper molecular material were obtained through high vacuum evaporation and were structurally characterized by IR spectroscopy, EPR and scanning electron microscopy (SEM). Additionally, the absorption coefficient (α) and photon energy (hν) were calculated from UV-vis spectroscopy and used to determine the optical activation energy in each film, from which its semiconducting behavior was established. An important aspect to consider is that the presence of hydrogen bonds is essential to establish the semiconducting nature of these species; this chemical behavior, as well as the resulting electronic mobility, have been studied by DFT theoretical calculations, which reinforce the experimental conclusion of a relationship between Cu(II)TAAB and TCNQ moieties generated by a weak bond. Finally, I-V characteristics have been obtained from a glass/ITO/doped molecular semiconductor/Ag device using Ag and ITO electrodes. Results for the copper-based device show that, at low voltages, the conduction process is of an ohmic nature while, at higher voltages, space-charge-limited current (SCLC) is found. It is highly probable that the doping effect in TCNQ favors electronic transport due to the formation of conduction channels caused by dopant-favored anisotropy.

[Cerebral cryptococcosis and immune reconstitution inflammatory syndrome. Case report]. / Criptococosis cerebral, voriconazol, niveles plasmáticos y síndrome de reconstitución inmune. Reporte de un caso.

We report a 45-year-old male with AIDS who had a Cryptococcus neoformans central nervous system infection. He was treated with amphotericin B deoxycholate subsequently changed to voriconazole due to systemic toxicity of the former. Plasma levels of voriconazole were insufficient with a standard dose (0.7 µg/mL), therefore, the dose was increased thereafter to reach appropriate levels (4.5 µg/mL). Anti-retroviral therapy was started five weeks after voriconazole initiation with non-interacting drugs and he was discharged after a favorable evolution. He was re-admitted three months later due to seizures; a brain magnetic resonance showed new sub-cortical nodules. After excluding alternative causes and demonstrating fungal eradication, an immune reconstitution inflammatory syndrome (IRIS) event was suspected and treated with a short course of steroids. His evolution was satisfactory.

From art to science: the functional damage due to thumb osteoarthritis finely described by Velazquez 300 years before its clinical description.

Velazquez showed to know the entity of thumb osteoarthritis by finely describing it in one of his paintings. The concepts of anatomical damage, loss of strenght, and functional impairment are transmitted to the observer.

El dolor posquirúrgico en las artroplastias del pulgar y su relación con la ergonomía articular y la función / Post-surgical pain in thumb arthroplasty and its relationship with joint ergonomy and function

Introducción En el pulgar degenerativo, suele transcurrir un periodo desde que la enfermedad aparece hasta que se realiza una artroplastia. Durante este periodo, se realizan movimientos compensatorios que desequilibran toda la columna del pulgar. El objetivo de nuestro estudio es comprobar la relación existente entre el dolor posquirúrgico a 6 meses de la intervención en las artroplastias del pulgar y la alineación de la columna del pulgar en la realización de las actividades cotidianas. Material y método Ensayo clínico controlado y aleatorizado, con una muestra de 28 pacientes. Criterios de inclusión: pacientes mayores de 18 años que han sido diagnosticados de rizartrosis en grado 2 (Eaton) y están en lista de espera para ser intervenidas, excluyendo patologías asociadas. Se distribuyeron de forma aleatoria en 2 grupos. Un grupo control, al que se le aplicó tratamiento con parafina, y el grupo de estudio, donde se realizó un programa de fisioterapia basado en la correcta utilización del pulgar en las actividades cotidianas para promover la correcta alineación y protección articular, ejercicios y férulas. Se utilizó la escala visual análoga para medir el dolor y el DASH para la función física. La valoración se realizó por la misma persona al inicio del estudio, previo a la intervención quirúrgica y a los 6 meses de la intervención. Resultados Se obtuvo una mejora significativa en los dos parámetros evaluados (p < 0,05).Conclusiones Se encontraron diferencias para las 2 variables estudiadas en el preoperatorio y a los 6 meses de la intervención. Podemos, además, establecer una relación lineal positiva entre el dolor y la función (AU)

Abstract Introduction In degenerative disease of the thumb, a period of time usually elapsed from the appearance of the disease to when the arthroplasty is performed. During this period, there are compensating movements that cause unbalance of the entire thumb canal. Our study has aimed to verify the relation existing between post-surgical pain at 6 months of the interention in arthroplasties of the thumb and the alignment of the canal of the thumb in performing daily activities. Material and method A randomized controlled clinical trial with a sample of 28 patients was conducted. Inclusion criteria: Patients over 18 who are diagnosed of rizarthrosis grade 2 (Eaton) and are on a waiting list to be operated on, excluding associated diseases. They were distributed randomly into two groups. A control group, to whom paraffin treatment was applied, and the study group in whom a physiotherapy program was carried out based on the correct use of the thumb in daily activities to promote proper alignment and joint protection, exercise and splints. Visual analogue scale was used to measure pain and the DASH for physical function. Assessment was performed by the same person at baseline, before surgery and at 6 months postoperatively. Results We obtained a significant improvement in both parameters evaluated (P<.05).Conclusions Differences were found for both variables in the preoperative and at six months after surgery. It has also been possible to establish a positive linear relationship between pain and function (AU)

Análisis de la estructura del síndrome psicótico agudo / Analysis of the structure of acute psychotic disorder

Introducción: La psicosis es una entidad clínicamente heterogénea. Estudios previos han encontrado una estructura multifactorial de dicho síndrome. El objetivo del presente estudio fue evaluar posibles categorías diagnósticas en pacientes con sintomatología psicótica aguda, a partir de las características de los síntomas en una evaluación transversal. Métodos: Se ensambló un instrumento a partir de las escalas SANS, SAPS, BPRS, EMUN y de depresión de Zung. Con base en criterios de redundancia y de tipo estadístico, un instrumento inicial de 101 ítems fue reducido a 57. El instrumento fue aplicado a 232 pacientes con sintomatología psicótica aguda no orgánica que asistieron a la Clínica de la Paz de Bogotá, y al Hospital San Juan de Dios, de Chía, entre abril del 2008 y diciembre del 2009. Se aplicaron técnicas estadísticas de análisis multivariado. Resultados: Casi 80% de los pacientes tuvo diagnóstico de esquizofrenia. El síndrome psicótico agudo se encontró conformado por los siguientes seis dominios: deficitario, agresivo-paranoide, desorganizado, depresivo, delirios extraños, alucinaciones. El análisis de conglomerados reveló ocho subtipos que, a partir de la estructura factorial, pueden denominarse así: 1) delirios extraños-alucinaciones; 2) deterioro y síntomas de desorganización; 3) deterioro; 4) deterioro con paranoia, ansiedad y agresividad; 5) delirios extraños; 6) paranoia, ansiedad, agresividad; 7) síntomas depresivos y delirios extraños; 8) paranoia, ansiedad, agresividad con síntomas depresivos. Conclusión: Los subtipos permiten una caracterización más exhaustiva que la que permiten los sistemas de clasificación vigentes. Es necesario validar estas agrupaciones en estudios longitudinales…

Introduction: Schizophrenia is a clinically heterogeneous disorder. A multifactorial structure of this syndrome has been described in previous reports. The aim of this study was to evaluate what are the possible diagnostic categories in patients having acute psychotic symptoms, studying their clinical characteristics in a cross-sectional study. Methods: An instrument for measuring psychotic symptoms was created using previous scales (SANS, SAPS, BPRS, EMUN, Zung depression scale). Using as criteria statistical indexes and redundance of items, the initial instrument having 101 items has been reduced to 57 items. 232 patients with acute psychotic symptoms, in most cases schizophrenia, attending Clínica Nuestra Señora de la Paz in Bogotá and Hospital San Juan de Dios in Chía have been evaluated from April, 2008 to December, 2009. Multivariate statistical methods have been used for analyzing data. Results: A six-factor structure has been found (Deficit, paranoid-aggressive, disorganized, depressive, bizarre delusions, hallucinations). Cluster analysis showed eight subtypes that can be described as: 1) bizarre delusions-hallucinations; 2) deterioration and disorganized behavior; 3) deterioration; 4) deterioration and paranoid-aggressive behavior; 5) bizarre delusions; 6) paranoiaanxiety- aggressiveness; 7) depressive symptoms and bizarre delusions; 8) paranoia and aggressiveness with depressive symptoms; Conclusion: These subtypes allow a more exhaustive characterization that those included in standard classification schemes and should be validated in longitudinal studies…

[Analysis of the Structure of Acute Psychotic Disorder]. / Análisis de la estructura del síndrome psicótico agudo.

INTRODUCTION: Schizophrenia is a clinically heterogeneous disorder. A multifactorial structure of this syndrome has been described in previous reports. The aim of this study was to evaluate what are the possible diagnostic categories in patients having acute psychotic symptoms, studying their clinical characteristics in a cross-sectional study. METHODS: An instrument for measuring psychotic symptoms was created using previous scales (SANS, SAPS, BPRS, EMUN, Zung depression scale). Using as criteria statistical indexes and redundance of items, the initial instrument having 101 items has been reduced to 57 items. 232 patients with acute psychotic symptoms, in most cases schizophrenia, attending Clínica Nuestra Señora de la Paz in Bogotá and Hospital San Juan de Dios in Chía have been evaluated from April, 2008 to December, 2009. Multivariate statistical methods have been used for analyzing data. RESULTS: A six-factor structure has been found (Deficit, paranoid-aggressive, disorganized, depressive, bizarre delusions, hallucinations). Cluster analysis showed eight subtypes that can be described as: 1) bizarre delusions-hallucinations; 2) deterioration and disorganized behavior; 3) deterioration; 4) deterioration and paranoid-aggressive behavior; 5) bizarre delusions; 6) paranoia-anxiety- aggressiveness; 7) depressive symptoms and bizarre delusions; 8) paranoia and aggressiveness with depressive symptoms CONCLUSION: These subtypes allow a more exhaustive characterization that those included in standard classification schemes and should be validated in longitudinal studies.

Effects of d-amphetamine on short- and long-term memory in spontaneously hypertensive, Wistar-Kyoto and Sprague-Dawley rats.

Diverse studies indicate that the attention deficit hyperactivity disorder (ADHD) is associated with alterations in encoding processes, including working or short-term memory. Some ADHD dysfunctional domains are reflected in the spontaneously hypertensive rat (SHR). Here SHR-saline group showed significantly poor STM and LTM relative to SD and WKY saline rats. SD and WKY rats treated with d-amphetamine displayed better STM and LTM, compared to SD-vehicle, WKY-vehicle or SHR-d-amphetamine groups.

Brain magnetic resonance imaging findings in acute relapses of neuromyelitis optica spectrum disorders.

We studied cranial magnetic resonance imaging (MRI) lesions in three women with acute attacks of recurrent longitudinally extensive transverse myelitis (r-LETM), recurrent-optic neuritis (r-ON) and r-LETM-CNS. Neuromyelitis Optica -immunoglobulin (IgG) antibody was positive in all cases. Brain MRI (1.5 Tesla) was performed according to protocol from consortium MS centre. We described the cranial lesions in brain MRI of acute relapses. These lesions were different from MS, most had an asymptomatic course which disappeared with time, protocol from consortium of MS centre criteria for brain MRI and seropositivity of NMO-IgG are useful tools for differentiate acute lesions of NMO/MS.

Flexores. Avances en fisioterapia / Flexor muscles. Advances in physical therapy

Introducción. A pesar de contradecir técnicasde rehabilitación tradicionales en las que se inicianlos ejercicios pasivos para posteriormente pasara los activos, con este protocolo se pretende inmovilizarselectivamente las articulaciones más proximalespermitiendo una movilización activa de la articulacióndistal.Material y método. Hemos documentado las lesionestendinosas traumáticas tratadas en nuestro centromediante movilización activa inmediata, comparandolos resultados con un grupo control en el que se haefectuado un protocolo de movilización pasivainmediata.Conclusiones. La utilización de esta técnica permitesolucionar tres problemas simultáneamente: a) resolverla debilidad articular y de tejidos blandos; b) cambiar el patrón de movilidad activa haciéndolo más productivo,y c) movilizar el edema crónico. Cuando se intenta disminuir el estrés de una articulación mediante la utilización de ortesis fijas, estamos dando origen a una debilidad que no puede ser tratada mediante movilizaciones pasivas. Sólo se han documentado efectos negativos de la movilización pasiva; además, una mejora del movimiento pasivo no se corresponde con una mejora de la movilidad activa. Los patrones anormales de movimiento originan cambios en la corteza somatosensorial. La recuperación de la movilidad abarca una rehabilitación mecánica y una reeducación de lospatrones normales de movimiento en la corteza.El empleo de esta metodología nos permite crearpatrones de movimiento deseados sin que aparezcanmovimientos compensatorios

Introduction. In spite of contradict techniques oftraditional rehabilitation where passive exercises arebegun in order to go to the active ones later, this protocol is expected to inmobilize selectively the most proximal articulations permiting an active mobilization of the distal articulation.Material and method. we have documented thetendinous injuries treated in our centre by inmediateactive mobilization and we have checked the results witha controlled group followed by immediate passivemobilization.Conclusions. the use of this technique,allows us to solvethree problems simultaneously. a) To solve the articularweakness and soft tissues; b) to change the active mobility pattern becoming more productive, and c) tTo mobilize the chronic oedema. When it is tried to reduce the stress of an articulation through the use of fixed orthosis, we are provoking a weakness of the passive mobilization which cannot be treated with passive mobilizations.Only negative effects have been researched, also a better passive movementwhich does not correspond with a better active mobility.The abnormal patterns of movement provoke changes atthe somesthetic cortex level. The recovery of the mobility cover a mechanic rehabilitation and normal patterns of movement rehabilitation at the cortex level.Using this methodology allows us to create movementpatterns wanted without the appearance of compensatorymovements

O-CAS, a fast and universal method for siderophore detection.

In this work, the popular CAS assay for siderophore detection, based on the utilization of chrome azurol S, was redesigned and optimized to produce a new, fast, non-toxic, and easy method to determine a wide variety of microorganisms capable of siderophore production on a solid medium. Furthermore, this specific bioassay allows for the identification of more than one single siderophore-producing microorganism at the same time, using an overlay technique in which a modified CAS medium is cast upon culture agar plates (thus its name "O-CAS", for overlaid CAS). Detection was optimized through adjustments to the medium's composition and a quantifying strategy. Specificity of the bioassay was tested on microorganisms known for siderophore production. As a result, a total of 48 microorganisms were isolated from three different types of samples (fresh water, salt water, and alkaline soil), of which 36 were determined as siderophore producers. The compounds identified through this method belonged to both hydroxamate and catechol-types, previously reported to cause color change of the CAS medium from blue to orange and purple, respectively. Some isolated microorganisms, however, caused a color change that differed from previous descriptions.

Brain magnetic resonance imaging findings in relapsing neuromyelitis optica.

BACKGROUND: Some studies showed abnormalities in brain magnetic resonance imaging (MRI) of relapsing neuromyelitis optica (R-NMO) from 12 to 46%. These abnormalities are described as compatible/non-compatible with multiple sclerosis (MS). OBJECTIVE: To describe the abnormal brain MRI lesions in R-NMO with imaging studies conducted with more sensitive white matter change techniques. METHODS: Thirty patients with R-NMO were selected. All MRI brain studies were performed with a 1.5-T Siemens MRI system according to the Standardized MR Imaging Protocol for Multiple Sclerosis from the Consortium of MS Centers Consensus Guidelines. RESULTS: Brain MRI images were evaluated in 29 R-NMO cases because in one case the MRI images were not appropriate for the study. Of these 29 brain MRI studies, 19 cases (65.5%) had at least one or more lesions (1-57) and 10 were negative (34.4%). Brain MRI findings in 19 cases were characterized in T2/fluid-attenuated inversion-recovery (FLAIR) by the presence of subcortical/deep white matter lesions in 16 (84.2%) cases (1-50), most of them <3 mm and without juxtacortical localization. Periventricular lesions were observed in 13 (68.4%) cases, but morphologically they were not oval, ovoid or perpendicularly orientated. Infratentorial lesions, all >3 mm, were observed in 4 (21.05%) cases without cerebellar involvement. T1 studies demonstrated absence of hypointense regions. Optic nerve enhancement was observed in 6/19 patients (31.5%). None of the brain MRI abnormalities observed were compatible with Barkhof et al. criteria of MS. CONCLUSIONS: This study, based on a Cuban patient population, with long duration of disease, good sample size and detailed characterization by MRI, demonstrated the brain MRI pattern of R-NMO patients, which is different from MS.

El fisioterapeuta y la mano del escalador / The physical therapist and the mountaineer’s hand

Las diversas modalidades de agarre utilizadas enla escalada deportiva pueden favorecer la apariciónde diferentes patologías menores tales como:lesiones de tejidos blandos, lesiones tendinosas(sobre todo en los flexores), tenosinovitis,contracturas, síndrome del túnel del carpo, etc.Otras lesiones, como por ejemplo roturas de poleas,lesiones completas de ligamentos, luxaciones articulareso roturas tendinosas, generalmente se deben a causastraumáticas.Hemos realizado una encuesta rutinaria en un grupode 97 escaladores de diferentes edades y experienciadeportiva para poder establecer qué tipo de patologíasson las más frecuentes, y plantear así la posibilidad deestablecer un protocolo de actuación. Este formulariose ha realizado en la Asociación de Escaladores deMálaga, y a pie de pista, en el Torcal de Antequera,El Chorro y la Cala del Moral.Se ha tenido en cuenta el tiempo (medido en horassemanales) que dedican a la escalada y la experienciadel deportista (años que lleva practicándola). Hemos dividido las patologías referidas en seis grupos:lesiones de tejidos blandos, lesiones de los flexores,roturas de la polea A2, lesiones articulares,ligamentosas y síndromes de compresión nerviosa.Aquellos casos en los que pudimos detectar secuelas(57 % presentaba deformidad en alguna de lasinterfalángicas proximales), fueron exploradosindividualmente para determinar la tipología,y valorar el estado actual.El gran porcentaje de lesiones por sobrecargasque sufren los escaladores, las secuelas permanentesy la inexistencia de una detección y tratamientoprecoz de las mismas, es lo que más nos llamala atención en este estudio

Different kinds of grip used in sports climb are ableto favour the appearance of different minor pathologiessuch as: soft tissue injuries, tendon injuries(at flexormuscles level overall), tenosynovitis, contracture,carpal tunnel syndrome.Other issues, as for example, rupture of pullies, ligamentinjuries, articular luxation or tendons rupture aregenerally caused by orthopaedics reasons.We have carried out a routine survey to a group of97 climbers from different ages,and sports experiencein order to establish what kind of pathologies aremost frequent and set out in this way the possibilityof establishing a protocol of proceedings.This form has been carried out by ClimbersAssociation from Málaga and in El Torcal (Antequera),El Chorro and La Cala del Moral.We have taken into account the time (basedon weekly hours) they dedicate to climband the experience of sportsmen/women(number of years that climbers have beenpractising). Referred pathologies have been divided into six groups:soft tissue injuries, flexor tendon injuries, rupture ofA2 pully, joints and ligaments injuries and nervouscompression syndrome.Those cases in which we could detect after-effect(57 % presented deformity at some of the proximalinterfalangeal joints level), they were exploredindividually to determine the typology, and to valuethe current conditions.In this study are relevant the great percentageof injuries by overload which climbers suffer,permanent after-effect and the non-existenceof a detection and an early treatment of suchinjuries(AU)