Myoglobinuria or rhabdomyolysis occurs when myoglobin escapes into the blood and then into the urine after acute muscle necrosis. It can be a serious medical condition leading to renal failure and death. There are many causes including exertion, crush syndromes, ischaemia, metabolic disorders, exogenous toxins and drugs, heat stroke and hereditary disorders such as malignant hyperthermia. We report the case of a 17 year-old boy who developed myoglobinuria, renal failure and death 11 days after ingesting sodium monensin, possibly with the intention of developing muscles. Sodium monensin, the active principle of Rumensin®, is a dietary additive used as a growth promoter for confined cattle. There are no previous reports of human intoxication. Accidental or experimental sodium monensin intoxication in animals produces similar findings to those seen in this case.
-This study was done to evaluate the long-term patient's satisfaction after carpal tunnel syndrome (CTS) electrodiagnostic done between 1989 and 1994 (5 to 10 years follow-up). Mail contact was made to 528 consecutive cases with a questionnaire to be filled; 165 patients responded after 19 exclusions. CTS severity was graded from 0 (incipient) to 4 (severe) after a combination of median sensory distal latency, sensory median-radial latency difference and amplitude of the median compound muscle action potential. Current symptoms ("cure", improved, unchanged or worsed) and the therapy utilized, either surgical or conservative, were analyzed to the initial CTS severity, age and duration of symptomatology. Surgical release was done in 114 cases (69%). Patient's satisfaction after surgical and non-surgical were respectively, 77.6% and 16% ("cure"), 13.6% and 52% (much improved), 5.4% and 9.3% (little improved), 2.7% and 16% (unchanged), 0.7% and 6.7% (worsed). The frequency of "cure" versus unchanged/worsed or "cure"/much improved versus unchanged/worsed was highly significative (Fisher, P-value < 0.001) and was not influenced by the CTS electrophysiological severity. There was no relationship between the outcome after surgery and duration of symptomatology, age or CTS severity. Conservative benefice was more prevalent in those with shorter symptomatology and older age; the majority of conservative failure cases had mild initial CTS. We concluded the excellent surgical benefice described by patients and the absence of any predictive factors based on CTS severity, age or duration of symptomatology for outcome.KEY WORDS: carpal tunnel syndrome, median nerve, compression neuropathy, electrodiagnosis, nerve conduction.Síndrome do túnel do carpo: avaliação evolutiva de longo prazo após confirmação eletrodiagnóstica Síndrome do túnel do carpo: avaliação evolutiva de longo prazo após confirmação eletrodiagnóstica Síndrome do túnel do carpo: avaliação evolutiva de longo prazo após confirmação eletrodiagnóstica Síndrome do túnel do carpo: avaliação evolutiva de longo prazo após confirmação eletrodiagnóstica Síndrome do túnel do carpo: avaliação evolutiva de longo prazo após confirmação eletrodiagnóstica RESUMO -O presente estudo tem por objetivo avaliar a terapia utilizada e o grau de satisfação dos pacientes que tiveram diagnóstico eletrofisiológico de síndrome do túnel do carpo (STC) entre 1989 e 1994 (528 casos); foram respondidas 184 cartas entre 528 enviadas (34,8%) sendo utilizadas 165. A gravidade do STC foi classificada de 0 a 4 de acordo com uma combinação de valores de latência distal sensitiva e amplitude do potencial de ação muscular composto do nervo mediano e diferença de latência sensitiva mediano/radial. As questões foram relativas a sintomatologia atual e terapêutica utilizada, cirúrgica ou conservadora. As respostas foram correlacionadas ao estudo de condução nervosa inicial, idade e tempo de sintomatologia. Os pacientes submetidos a cirurgia somaram 69% (114 casos). O benefício cirúrgico e não cirú...
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