Browsing by Author "Verdugo, Renato"
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Item Descripción electrofisiológica del síndrome de túnel carpiano según edad en pacientes adultos(2017) Vicuña, Pilar; Idiáquez, Juan Francisco; Jara, Paula; Pino, Francisca; Cárcamo, Marcela; Cavada, Gabriel; Verdugo, RenatoBackground: Carpal tunnel syndrome (CTS) represents 90% of entrapment neuropathies. Severity may be greater in older patients. Aim: To describe the electrophysiological findings in adult patients with CTS and determine if severity is related to age. Material and Methods: Descriptive and retrospective study of electrophysiological findings in patients over 18 years of age with clinical suspicion of CTS, studied between January 2011 and December 2015. Neurophysiological severity was classified in 3 grades, comparing them by age, gender and laterality. Results: Of 1156 patients subjected to electrophysiological studies due to a clinical suspicion of CTS, 690 (60%) had electrophysiological features of the disease. In 274 patients (24%) the compromise was mild, in 162 (14%) it was moderate and in 254 (22%) it was severe. There was a positive association between age and CTS severity (p < 0.01). Severity was significantly greater in males than females (p<0.01). Bilateral CTS was present in 471 patients (68%), which was associated with increased age and severity (p < 0.01). Conclusions: Electrophysiological severity in CTS increases with age. Other factors associated with higher severity are male gender and bilateral disease.Item Polirradiculoneuritis aguda asociada a infección por Virus Herpes Humano 7 en un paciente adulto inmunocompetente(2017) Jara, Paula; Verdugo, Renato; Thompson, LuisEl Virus Herpes Humano 7 (VHH-7), es un virus DNA de doble cadena, neurotrópico y linfotrópico, que pertenece a la subfamilia de los herpes virus. Está presente en 96 a 100% de la población adulta, el 70% de los casos se infectan durante los primeros 5 años de vida y el 30% restante más tardíamente. Es transmitido por vía oral y posterior a la infección primaria se mantiene latente en los linfocitos T CD4+ y en las células epiteliales de las glándulas salivales. La primoinfección durante la niñez se ha asociado principalmente con cuadros de exantema súbito, pitiriasis rosada y crisis febriles1,2. En la población adulta tanto la primoinfección como la reactivación del virus se ha asociado a compromiso neurológico, desde encefalitis y meningitis a cuadros de mielitis, estos últimos casos pueden asociarse o no a polirradiculitis y compromiso de pares craneanos3–5. Estas manifestaciones neurológicas se han presentado en pacientes inmunocompetentes e inmunodeprimidos, correspondiendo algunos de ellos a reactivación de la infección previamente adquirida y en otros a infección primaria en la adultez1,2. Comunicamos el caso clínico de un paciente adulto inmunocompetente que presentó una polirradiculitis aguda asociada a (VHH-7), sin mielitis ni otro compromiso del Sistema Nervioso Central (SNC).Publication Review of techniques useful for the assessment of sensory small fiber neuropathies: Report from an IFCN expert group.(2022) Verdugo, Renato; Matamala, José; Inui, Koji; Kakigi, Ryusuke; Valls-Solé, Josep; Hansson, Per; Nilsen, Kristian Bernhard; Lombardi, Raffaella; Lauria, Giuseppe; Petropoulos, Ioannis N.; Malik, Rayaz A.; Treede, Rolf-Detlef; Baumgärtner, Ulf; Jara, Paula A.; Campero, MarioNerve conduction studies (NCS) are an essential aspect of the assessment of patients with peripheral neuropathies. However, conventional NCS do not reflect activation of small afferent fibers, including Aδ and C fibers. A definitive gold standard for laboratory evaluation of these fibers is still needed and therefore, clinical evaluation remains fundamental in patients with small fiber neuropathies (SFN). Several clinical and research techniques have been developed for the assessment of small fiber function, such as (i) microneurography, (ii) laser evoked potentials, (iii) contact heat evoked potentials, (iv) pain-related electrically evoked potentials, (v) quantitative thermal sensory testing, (vi) skin biopsy-intraepidermal nerve fiber density and (vii) corneal confocal microscopy. The first five are physiological techniques, while the last two are morphological. They all have advantages and limitations, but the combined use of an appropriate selection of each of them would lead to gathering invaluable information for the diagnosis of SFN. In this review, we present an update on techniques available for the study of small afferent fibers and their clinical applicability. A summary of the anatomy and important physiological aspects of these pathways, and the clinical manifestations of their dysfunction is also included, in order to have a minimal common background.Item Thymectomy for non-thymomatous myasthenia gravis(John Wiley & Sons, 2013) Cea, Gabriel; Benatar, Michael; Verdugo, Renato; Salinas, RodrigoBACKGROUND: Treatments currently used for patients with myasthenia gravis (MG) include steroids, non-steroid immune suppressive agents, plasma exchange, intravenous immunoglobulin and thymectomy. Data from randomized controlled trials (RCTs) support the use of some of these therapeutic modalities and the evidence for non-surgical therapies are the subject of other Cochrane reviews. Significant uncertainty and variation persist in clinical practice regarding the potential role of thymectomy in the treatment of people with MG. OBJECTIVES: To assess the efficacy and safety of thymectomy in the management of people with non-thymomatous MG. SEARCH METHODS: On 31 March 2013, we searched the Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL (2013, Issue 3), MEDLINE (January 1966 to March 2013), EMBASE (January 1980 to March 2013) and LILACS (January 1992 to March 2013) for RCTs. Two authors (RS and GC) read all retrieved abstracts and reviewed the full texts of potentially relevant articles. These two authors checked references of all manuscripts identified in the review to identify additional articles that were of relevance and contacted experts in the field to identify additional published and unpublished data. Where necessary, authors were contacted for further information. SELECTION CRITERIA: Randomized or quasi-randomized controlled trials of thymectomy against no treatment or any medical treatment, and thymectomy plus medical treatment against medical treatment alone, in people with non-thymomatous MG.We did not use measured outcomes as criteria for study selection. DATA COLLECTION AND ANALYSIS: We planned that two authors would independently extract data onto a specially designed data extraction form and assess risk of bias; however, there were no included studies in the review. We would have identified any adverse effects of thymectomy from the included trials. MAIN RESULTS: We did not identify any RCTs testing the efficacy of thymectomy in the treatment of MG. In the absence of data from RCTs, we were unable to do any further analysis. AUTHORS' CONCLUSIONS: There is no randomized controlled trial literature that allows meaningful conclusions about the efficacy of thymectomy on MG. Data from several class III observational studies suggest that thymectomy could be beneficial in MG. An RCT is needed to elucidate if thymectomy is useful, and to what extent, in MG.