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      Factores asociados con la calidad de vida en pacientes con síndrome de túnel carpiano Translated title: Factors associated with quality of life in patients with carpal tunnel syndrome

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          Abstract

          Introducción. Este estudio determina los factores asociados con el deterioro en la calidad de vida en pacientes con síndrome de túnel carpiano (STC). Materiales y métodos. Se aplicó un cuestionario con variables demográficas, clínicas, el EQ-5D y el Boston Carpal Tunnel Questionnaire con las subescalas de síntomas (BCTQ SSS) y funcional (BCTQ FSS) a pacientes mayores de 18 años de edad con diagnóstico confirmado mediante estudios electrodiagnóstico de STC a los 0 y 6 meses. Resultados. Participaron 53 pacientes (71,7% mujeres) con una edad promedio de 55,5 (±13) años. Las puntuaciones del EQ-5D al inicio y a los 6 meses fueron de 0,55 (±0,30) y 0,81 (±0,23) respectivamente. El BCTQ SSS fue de 2,28 (±0,78) y 2,05 (±0,83) y el BCTQ FSS fue de 2,29 (±0,85) y 1,80 (±0,76) al inicio y a los 6 meses respectivamente. El dominio del EQ-5D que presentó mayor proporción de pacientes (90,5%) en calificaciones de moderado y severo fue "dolor". Los pacientes que recibieron tratamiento quirúrgico presentaron mejores puntajes solamente en el EQ-5D en comparación a los que recibieron tratamiento médico (0,92 vs. 0,77; p=0,02). Los factores relacionados con peores valoraciones subjetivas fueron: clasificación de "severo" en los estudios de velocidad de conducción nerviosa y clasificación de "moderado" en el dominio de "actividades de la vida diaria" y "dolor" en el EQ-5D. Conclusión. El compromiso en la calidad de vida está asociado a la afectación de las actividades de la vida diaria, la presencia de dolor y evidencia de mayor daño en el estudio electrofisiológico.

          Translated abstract

          Introduction. This study identifies the factors associated with the deterioration in the quality of life in patients with carpal tunnel syndrome (CTS). Materials and methods. A questionnaire with demographic and clinical variables, the EQ-5D and the Boston Carpal Tunnel Questionnaire with symptoms (BCTQ SSS) and functional (BCTQ FSS) subscales were applied to patients over 18 years of age with a diagnosis confirmed by electrodiagnostic studies. Results. The study involved 53 patients (71,7% women) with a mean age of 55,5 (± 13) years. The EQ-5D scores at baseline and 6 months were 0,55 (± 0,30) and 0,81 (± 0,23) respectively. The BCTQ SSS was 2,28 (± 0,78) and 2,05 (± 0,83) and BCTQ FSS was 2,29 (± 0,85) and 1,80 (± 0,76) to baseline and 6 months respectively. The domain of the EQ-5D showed higher proportion of patients (90,5%) in scores was moderate to severe "pain." Patients who received surgical treatment only showed better scores in the EQ-5D compared to those who received medical treatment (0,92 vs 0,77; P = 0,02). Factors associated with worse subjective assessments were rated "severe" in studies of nerve conduction velocity and classification of "moderate" in the domain of "activities of daily living" and "pain" in the EQ-5D. Conclusion. The impact on the quality of life is associated with impairment of activities of daily living, the presence of pain and evidence of major damage in the electrophysiological study.

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          Most cited references35

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          Carpal tunnel syndrome: prevalence in the general population.

          To study the prevalence of carpal tunnel syndrome (CTS) in the general population and the value of brachialgia paraesthetica nocturna (BPN) in diagnosing CTS, an age and sex stratified random sample of 715 subjects was taken from the population register of Maastricht (The Netherlands) and surrounding villages, between September 1983 and July 1985. The response rate was 70%. Of these, 12 CTS cases had already been diagnosed. Of the remaining subjects, 64 (13 men, 51 women) woke up because of BPN. Among these subjects 1 man and 23 women were found to have CTS. The prevalence rate of undetected CTS was 5.8% [95% confidence interval (CI): 3.5-8.1%] in adult women; 3.4 percent (95% CI: 1.5-5.3%) had already been diagnosed as CTS. The overall prevalence rate for men was 0.6% (95% CI 0.02-3.4%). These figures have to be regarded as minimal estimates. The overall diagnostic value of BPN for CTS was 38%, while for women only this was 45% (95% CI: 31-60%).
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            Is surgical intervention more effective than non-surgical treatment for carpal tunnel syndrome? a systematic review

            Background Carpal tunnel syndrome is a common disorder in hand surgery practice. Both surgical and conservative interventions are utilized for the carpal tunnel syndrome. Although certain indications would specifically indicate the need for surgery, there is a spectrum of patients for whom either treatment option might be selected. The purpose of this systematic review was to compare the efficacy of surgical treatment of carpal tunnel syndrome with conservative treatment Methods We included all controlled trials written in English, attempting to compare any surgical interventions with any conservative therapies. We searched Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2010), MEDLINE (1980 to June 2010), EMBASE (1980 to June 2010), PEDro (searched in June 2010), international guidelines, computer searches based on key words and reference lists of articles. Two reviewers performed study selection, assessment of methodological quality and data extraction independently of each other. Weighted mean differences and 95% confidence intervals for patient self-reported functional and symptom questionnaires were calculated. Relative risk (RR) and 95% confidence intervals for electrophysiological studies and complication were also calculated. Results We assessed seven studies in this review including 5 RCTs and 2 controlled trials. The methodological quality of the trials ranged from moderate to high. The weighted mean difference demonstrated a larger treatment benefit for surgical intervention compared to non surgical intervention at six months for functional status 0.35( 95% CI 0.22, 0.47) and symptom severity 0.43 (95% CI 0.29, 0.57). There were no statistically significant difference between the intervention options at 3 months but there was a benefit in favor of surgery in terms of function and symptom relief at 12 months ( 0.35, 95% CI 0.15, 0.55 and 0.37, 95% CI 0.19 to 0.56). The RR for secondary outcomes of normal nerve conduction studies was 2.3 (95% CI 1.2, 4.4), while RR was 2.03 (95% CI 1.28 to 3.22) for complication, both favoring surgery. Conclusion Both surgical and conservative interventions had treatment benefit in carpal tunnel syndrome. Surgical treatment has a superior benefit, in symptoms and function, at six and twelve months. Patient underwent surgical release were two times more likely to have normal nerve conduction studies but also had complication and side effects as well. Given the treatment differential and potential for adverse effects and that conservative interventions benefitted a substantial proportion of patients, current practice of a trial of conservative management with surgical release for severe or persistent symptoms is supported by evidence.
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              Health-Related Quality of Life as Measured with EQ-5D among Populations with and without Specific Chronic Conditions: A Population-Based Survey in Shaanxi Province, China

              Introduction The aim of this study was to examine health-related quality of life (HRQoL) as measured by EQ-5D and to investigate the influence of chronic conditions and other risk factors on HRQoL based on a distributed sample located in Shaanxi Province, China. Methods A multi-stage stratified cluster sampling method was performed to select subjects. EQ-5D was employed to measure the HRQoL. The likelihood that individuals with selected chronic diseases would report any problem in the EQ-5D dimensions was calculated and tested relative to that of each of the two reference groups. Multivariable linear regression models were used to investigate factors associated with EQ VAS. Results The most frequently reported problems involved pain/discomfort (8.8%) and anxiety/depression (7.6%). Nearly half of the respondents who reported problems in any of the five dimensions were chronic patients. Higher EQ VAS scores were associated with the male gender, higher level of education, employment, younger age, an urban area of residence, access to free medical service and higher levels of physical activity. Except for anemia, all the selected chronic diseases were indicative of a negative EQ VAS score. The three leading risk factors were cerebrovascular disease, cancer and mental disease. Increases in age, number of chronic conditions and frequency of physical activity were found to have a gradient effect. Conclusion The results of the present work add to the volume of knowledge regarding population health status in this area, apart from the known health status using mortality and morbidity data. Medical, policy, social and individual attention should be given to the management of chronic diseases and improvement of HRQoL. Longitudinal studies must be performed to monitor changes in HRQoL and to permit evaluation of the outcomes of chronic disease intervention programs.
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                Author and article information

                Journal
                anco
                Acta Neurológica Colombiana
                Acta Neurol Colomb.
                Asociación Colombiana de Neurología (Bogotá, Distrito Capital, Colombia )
                0120-8748
                2422-4022
                April 2014
                : 30
                : 2
                : 82-88
                Affiliations
                [01] Cali orgnameUniversidad Icesi orgdiv1Centro de Estudios en Protección Social y Economía de la Salud PROESA Colombia
                [02] Cali orgnameUniversidad Icesi orgdiv1Facultad de Ciencias de la Salud Colombia cguevara@ 123456icesi.edu.co
                Article
                S0120-87482014000200004 S0120-8748(14)03000204
                5b86654a-4488-4669-9557-82a70b26d84f

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 18 January 2014
                : 15 February 2014
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 20, Pages: 7
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                SciELO Colombia

                Categories
                Artículos originales

                Evaluación de Desenlaces en pacientes,Nervio Periférico,Quality of Life,Peripheral Nerve,Patient Outcome Assessment,Síndrome de Túnel Carpiano,Calidad de Vida,Carpal Tunnel Syndrome

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