@PJ1wZhN`~*/2-DI\CK{NX{,F B 0f^DXOwrGVcb4O4]:bi4|*o ,QUZ z JGxT." stream 0000141719 00000 n Ball or sock squeeze Hold a tennis ball (or a rolled-up sock) in your hand. It is sometimes called tennis elbow, although it can occur with many activities. Repetitive wrist dorsiflexion with supination and pronation causes overuse of the extensor tendons of the forearm and subsequent microtears, collagen degeneration, and angiofibroblastic proliferation. Rotator Cuff and Shoulder Conditioning Program, Therapeutic Exercise Program for Epicondylitis (Tennis Elbow / Golfers Elbow). JavaScript seems to be disabled in your browser. Slo su mdico puede diagnosticar y tratar un problema de salud. However, you may experience symptoms differently. Use your other hand to pull the wrist back toward your body. Otras causas de codo de tenista incluyen: Pintar con un cepillo o rodillo. Puede ser peor al mover o usar el codo, el antebrazo o la mueca. Causes Usually secondary to overuse or repetitive use Populations at risk: athletes and manual laborers History Pain at the lateral epicondyle 0000039971 00000 n You may do the strengthening exercises when stretching is nearly painless. Tennis elbow (lateral epicondylitis) and golfer's elbow (medial epicondylitis) are painful conditions caused by overuse. The pain is typically located just distal to the lateral epicondyle over the extensor tendon mass. HOk1st Tambin puede que necesite evitar ciertos tipos de actividades deportivas y laborales por algn tiempo. If symptoms continue despite numerous treatment approaches, referral may be warranted. Otras causas de codo de tenista incluyen: Uso frecuente de otras herramientas de mano en forma continua, Uso de movimientos repetidos de mano en varias profesiones, como cortadores de carne, msicos, dentistas y carpinteros. %%EOF These stretches should be held for 20-30 seconds and repeated 5-10 times, at least twice a day. 0000003565 00000 n Tomar analgsicos de venta libre o recetados puede ayudar a reducir el dolor y la hinchazn. 0000203347 00000 n during this exercise. El tendn que est ms probablemente involucrado en el codo de tenista es el extensor carpi radialis brevis y esta condicin se diagnostica usualmente en hombres y mujeres entre los 30 y 50 aos de edad. Tennis elbow is generally caused by overuse of the extensor tendons of the forearm, particularly the extensor carpi radialis brevis. Core Strengthening Exercises on Stomach or Side. 0000005544 00000 n At Another Johns Hopkins Member Hospital: Elbow Problems in Little League Baseball Players, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov. ?uXP.jPgJfnr Pl9;d1J The surgery would be performed in an outpatient setting. 0000199142 00000 n Your pain should ease within 2 weeks and you should recover over approximately a 4-6 week period. Magnetic resonance imaging (MRI) can show your tendons and how severe the damage is. 0000002024 00000 n You should carry on with the exercises overleaf for at least 6-8 weeks after %PDF-1.6 % +^9K1T-^Uu ^+f5BH|q7w f*\ A study showed that, compared with an orthosis (i.e., an inelastic, nonarticular, proximal forearm strap [tennis elbow brace]), injection decreased pain at two weeks, but patient-perceived outcomes were no different at six months.10 Several studies found that oral NSAIDs and physiotherapy have greater benefits than corticosteroid injection at intermediate-term follow-up (greater than six weeks) and long-term follow-up (greater than six months), respectively.5,11,12 Studies comparing various corticosteroid injections found no clinically significant differences.8,9 Although corticosteroid injections are effective in the short-term, their long-term effectiveness and advantages over other conservative treatments are uncertain. Extracorporeal shock wave therapy, laser treatment, and electromagnetic field therapy do not appear to be effective. Tennis elbow (lateral epicondylitis) and golfer's elbow (medial epicondylitis) are painful conditions caused by overuse. 0000004098 00000 n [E+;C~Ik8i$F5p ;FB%-R*%-#k7N!5b!8ws&p'[. ye,df"(u#D:Du6C`; m]u> O\9@U,`h@z>aJ 2Ujo}=|3T[^}'-A\B"JzDM)`RV\@*6j}}~! 0000000016 00000 n 1\cdbH`c``bH3*#+E\I Esta informacin no pretende sustituir la atencin mdica profesional. -:Hv3tDbJ$8 :# 'GP`{Wu D;=4iDi-)!7!g 0000098687 00000 n Slowly (over five seconds) move the wrist back to the original . .Fi| j Ask a Doctor: Lateral Epicondylitis (Tennis Elbow). endstream endobj 36 0 obj <> endobj 37 0 obj <> endobj 38 0 obj <>stream 0000010627 00000 n No significant differences were found in grip strength or range of motion, and none of the studies evaluated quality of life or time to return to work. The problem can be caused by any repetitive movement. Qty. Slowly turn your palm downward and hold for 5 seconds. Repeat 8 to 12 times. ~NV:}!pk?m~K- xUk7TG3%$:6fV370f-\`^ At six months, 81 percent of treated patients were asymptomatic during activities of daily living.30, Surgery is often recommended when conservative strategies fail to relieve lateral epicondylitis symptoms after six to 12 months. endstream endobj startxref Three studies have shown pain reduction and improvement in subjective function with NSAID iontophoresis (using diclofenac or pirprofen [not available in the United States]) after two to four weeks.15,20 There is no good evidence supporting the use of corticosteroid iontophoresis.15,20 One meta-analysis and one systematic review found limited evidence against the use of electromagnetic field therapy.5,20, Ultrasonography is thought to have thermal and mechanical effects on the target tissue leading to increased metabolism, circulation, extensibility of connective tissue, and tissue regeneration.23 The best available data suggest that ultrasonography provides modest pain reduction over one to three months.15,1921 Exercise appears to be more effective than ultrasonography for pain relief.15,19 Combining ultrasonography with deep transverse friction massage or corticosteroids is no better than ultrasonography alone.15,22, Deep transverse friction massage is thought to realign abnormal collagen fiber structure, break up adhesions and scar tissue, and increase healing with hyperemia.22 There is insufficient evidence to form conclusions about deep transverse friction massage for the treatment of lateral epicondylitis.22, A consensus statement from the National Institutes of Health states that study results are promising enough to consider acupuncture as an appropriate option for the treatment of lateral epicondylitis.24 However, conflicting evidence exists, and recommendations for or against this therapy cannot be made. COVID-19 updates, including vaccine information, for our patients and visitors Learn More. 0000006170 00000 n Skip to the beginning of the images gallery, English Version Available, Treatment options: rest and medication, exercises and therapy, anti-inflammatory injections, surgery, 6 panels, full-color photography, anatomical artwork. Puede ser por cualquier actividad que sobrecargue repetidamente los msculos extensores del antebrazo o los tendones y la mueca. 0000029064 00000 n Tennis elbow may be caused by: Using a tennis racket that is too tightly strung or too short, Other racquet sports, like racquetball or squash, Hitting the ball off center on the racket, or hitting heavy, wet balls. 0000009971 00000 n One RCT found that at one year a watchful-waiting approach was comparable with physical therapy and superior to corticosteroid injection in alleviating a patient's main complaint.5 Patients in the watchful-waiting group visited their primary care physician once during the six-week intervention period.5 Avoidance of aggravating activities and practical solutions were recommended. Topical nonsteroidal anti-inflammatory drugs, corticosteroid injections, ultrasonography, and iontophoresis with nonsteroidal anti-inflammatory drugs appear to provide short-term benefits. Do 3 sets on each hand. Enviar bsqueda de la biblioteca de salud, Medial Epicondylitis (Golfer's and Baseball Elbow). Physical therapy regimens, including strength training and stretching, are commonly used to treat lateral epicondylitis. Lateral epicondylitis, commonly known as "tennis elbow," is a painful condition involving the tendons that attach to the bone on the outside (lateral) part of the elbow. hX{o*?v*gRv{W` !&Og&B{:Ec7|]&mh. En muchos casos, el cirujano quitar el tejido daado. Advice from a Certified Hand Therapist: What is Tennis Elbow? 389 0 obj <>stream 0000198888 00000 n A tendon is a tough cord of tissue that connects muscles to bones. !D`ftcGS+;u/IXX$(} Exercise. Exercises often help too. endstream endobj 48 0 obj <>stream Otherwise, the . 2000-2023 The StayWell Company, LLC. Lateral epicondylitis, or tennis elbow, involves the muscles and tendons of your forearm that are responsible for the extension of your wrist and fingers. Imaging studies are rarely required for diagnosis. Uso de una raqueta que est encordada muy ajustadamente o que es demasiado corta, como por ejemplo una que sea para raquetbol o squash. 619-471-9045. Un movimiento repetitivo causa la condicin. Lateral epicondylitis is diagnosed by an exam of the elbow joint. Un movimiento repetitivo causa la condicin. Puede sentirlo en la parte externa del codo y a lo largo de la parte posterior del antebrazo. from the American Academy of Orthopaedic Surgeons. 0 Inicialmente, puede sentir dolor a lo largo de la parte externa del antebrazo y del codo. GREG W. JOHNSON, MD, KARA CADWALLADER, MD, SCOT B. SCHEFFEL, MD, AND TED D. EPPERLY, MD. Two systematic reviews and one meta-analysis found that acupuncture leads to short-term (three days to two months) pain reduction.15,20,25 Two additional systematic reviews acknowledge that acupuncture might provide short-term benefit, but they conclude that there is insufficient evidence on the use of acupuncture for the treatment of lateral epicondylitis.7,26. Forearm pronation and supination: With your elbow bent 90, turn your palm upward and hold for 5 seconds. Topical NSAIDs may provide short-term pain relief.6,7 Three studies have examined the effects of diclofenac (Solaraze) and benzydamine (not available in the United States) for up to three weeks. The muscle involved in this condition, the extensor carpi radialis brevis, helps to straighten and stabilize the wrist (Figure 1).With lateral epicondylitis, there is degeneration of the tendons attachment, weakening the anchor site and placing greater stress on the area. %PDF-1.6 % %%EOF 2000-2023 The StayWell Company, LLC. El dolor tambin puede persistir cuando el brazo y la mano estn colocados con la palma hacia abajo en una mesa y la persona trata de levantar la mano contra resistencia, o cuando levanta o toma objetos pequeos, tales como una taza de caf. Lateral epicondylitis is commonly referred to as . 0000008682 00000 n Puede ser una opcin si otros tratamientos no ayudan a aliviar los sntomas. The healthcare provider may need an X-ray or MRI to see whats causing the problem. Symptoms include pain at the lateral epicondyle of the elbow, which can radiate into the forearm. Use of a tennis elbow brace (usually for a few weeks) can be beneficial. Sports such as tennis are commonly associated with this, but the problem can occur with many different activities. Deber evitar los movimientos que pueden empeorar los sntomas. endstream endobj 46 0 obj [/ICCBased 54 0 R] endobj 47 0 obj <>stream Make sure you keep your elbow at your side and bent 90 throughout this exercise. Do 3 sets on each hand. HlT=0+8J@Jn=:t*PKg+gJR2IG>*;gb{} z~em FO*J>C|ex?mU6)gdMIX%lyJX2JKA1D=Fad -`I.SoXjP09 Es muy importante que use la frula adecuadamente. 0000007468 00000 n Your forearm tendons often called extensors attach the muscles to bone. Surgery is only considered when the pain is incapacitating and has not responded to other treatments, and when symptoms have lasted six to 12 months. Elbow and Wrist Flexibility and Strengthening Exercises. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. The healthcare provider may need an X-ray or MRI to see what's causing the problem. With activity, the pain usually starts at the elbow and may travel down the forearm to the hand. Masks are required inside all of our care facilities. 365 0 obj <>/Filter/FlateDecode/ID[<744145B267006D46B40DF678ECE448E7><7FB80C48AC124E41B0D698259C72912A>]/Index[341 49]/Info 340 0 R/Length 119/Prev 811194/Root 342 0 R/Size 390/Type/XRef/W[1 3 1]>>stream There are numerous surgical approaches, including open, percutaneous, and arthroscopic techniques. 0000032525 00000 n Siempre consulte a su mdico para un diagnstico. El tratamiento puede incluir:, Aplicacin de compresas fras (para reducir la inflamacin), Francesca Torriani, MD This content is owned by the AAFP. Lateral epicondylitis Injury to the lateral aspect of the elbow is the most common upper extremity tennis injury. Tambin puede sentir dolor al tomar o levantar cosas. If these treatments do not work, your healthcare provider may talk to you about: Bracing the area to keep it still for a few weeks or use of a special brace with activities, Steroid injections to help reduce swelling and pain, A special type of ultrasound that can help break up scar tissue, increase blood flow, and promote healing, Warm up before exercising or using your arms for sports or other repetitive movements, If you play a racquet sport, make sure your equipment is right for you, If pain or trouble moving affects your regular daily activities, If your pain doesnt get better, or it gets worse with treatment. Study Design Randomized controlled study Introduction Lateral epicondylitis (LE) causes pain and loss of function in the affected limb. Your healthcare provider can usually diagnosis your tennis elbow by a physical exam. The pain is located on the outside of the elbow, over the bone region known as the lateral epicondyle. Sobre la base de un examen fsico se realiza usualmente el diagnstico del codo de tenista. To ensure that this program is safe and effective for you, it should be performed under your doctor's supervision. Lo siguiente puede causar el codo de tenista: Msculos dbiles del hombro y de la mueca. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. You may also feel pain when you try to lift and grip small objects, such as a coffee cup. Los msculos del antebrazo, que se unen al lado exterior del codo, pueden tornarse dolorosos debido a un esfuerzo excesivo. 0000007781 00000 n 4 0 obj Lateral epicondylitis (LE), commonly known as 'tennis elbow', where pain persists for 6 weeks or more; however, earlier institution of exercise might also confer benefit. Lateral epicondylitis (Tennis Elbow) is the most frequent type of myotendinosis and can be responsible for substantial pain and loss of function of the affected limb. during this exercise. hb```a``:( @1V,F ? ]SrHGonvHA_N;{c=Uw4Qya,t>zTrYqPf(6Yh"95g&~%Y*/9l7[2jUHe0X h :4;Pb2Lbusf "pUPU f 0000002669 00000 n HO0|9PlR^KUI`L~vi'(X&J(N49FQ4kg7C;hgov%2Lh .U"E+ (I ~4_Z?OoSYBD5r< *r(k)e!4R$RC*(2 In some cases, you may certain tests, such as: An X-ray to look at the bones of your elbow to see if you have arthritis in your elbow. Dado que esta afeccin a veces puede ser causa de jugar al tenis, tambin se llama codo de tenista. The elbow should be extended and not flexed to increase the amount of stretch as required. 0000006838 00000 n A recent systematic review found that laser therapy had no effect on pain at six weeks; longer-term results were conflicting.19 Pooled data from six studies on short- and long-term outcomes show no difference between laser therapy and placebo.15 These results are reinforced by another systematic review that found evidence against the use of laser therapy alone or in conjunction with other conservative modalities.20, Table 1 summarizes the physical therapy modalities that are effective for the treatment of lateral epicondylitis.15,1922. %PDF-1.4 % Different exercises have been used for the treatment of LE . . We are vaccinating all eligible patients. Strengthening exercises Most procedures excise abnormal tissue within the origin of the extensor carpi radialis brevis tendon at the lateral epicondyle or release the tendon altogether. Lateral epicondylitis, also known as tennis elbow, is a common condition that is estimated to affect 1% to 3% of the population. Lateral Epicondylitis Discharge Instructions. UC San Diego | School of Medicinetoday = new Date(); document.write("Copyright © ", today.getFullYear()); Lateral epicondylitis is one of the most common overuse syndromes seen in primary care, with an annual incidence of 1 to 3 percent; the condition affects men and women equally.1 Patients with lateral epicondylitis are typically 40 years or older and have a history of repetitive activity during work or recreation. startxref 19 0 obj <> endobj endstream endobj 37 0 obj <> endobj 38 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC]/Properties<>/Prop2<>/Prop3<>/Prop4<>/Prop5<>>>/XObject<>>>/Rotate 0/TrimBox[0.0 0.0 836.221 595.276]/Type/Page>> endobj 39 0 obj <>stream This helpful brochure, now updated with a fresh new look and full-color photography, engages readers and aids comprehension of lateral epicondylitis (tennis elbow). Objective this study was done to assess the therapeutic efficacy of forearm support band and wrist splint in minimizing severity of pain and improving hand grip strength with lateral epicondylitis . 0000002804 00000 n Regents of the University of California. A muscle involved in tennis elbow - the extensor carpi radialis brevis - helps to extend and stabilize the wrist, Using this search tool means you agree to the, 2023 American Society for Surgery of the Hand, from the American Society for Surgery of the Hand. #html-body [data-pb-style=SKLPFDJ]{justify-content:flex-start;display:flex;flex-direction:column;background-position:left top;background-size:cover;background-repeat:no-repeat;background-attachment:scroll;border-style:none;border-width:1px;border-radius:0;margin:0 0 10px;padding:10px}#html-body [data-pb-style=AANGDIX]{border-style:none;border-width:1px;border-radius:0;margin:0;padding:0}. View Show abstract ZvZ[bX}+a ~JyvO1e1!$~x3|_r,u NM?]>haotwf23upo7;p=4F7HvhP*F La epicondilitis lateral afecta los tendones que conectan los msculos del antebrazo al epicndilo lateral. 2017 American Society for Surgery of the Hand. 0000009271 00000 n 0000001844 00000 n The muscles and tendons become sore from excessive strain. To date, no studies have investigated this treatment method in patients with medial epicondylalgia. Click here to view and download this handout. The median follow-up period was only two weeks, and long-term outcomes were not reported. 0000187186 00000 n Los tendones son bandas de tejidos resistentes que conectan los msculos con los huesos. This area can become tender to the touch. The word epicondylitis suggests inflammation . xj$I7YE#'lt 5R%vq@{t\IvZ.`X/k|#;g?du*CVE: a0cqIwgiqQjw^S. Copyright 2023 American Academy of Family Physicians. Lateral epicondylitis, commonly known as tennis elbow, is a painful condition involving the tendons that attach to the bone on the outside (lateral) part of the elbow. endstream endobj 33 0 obj <> endobj 34 0 obj <> endobj 35 0 obj <>stream The RCT of 86 patients compared a nitroglycerin transdermal patch with a placebo patch. 129 0 obj <>stream 0000199364 00000 n Recovery can be expected to take several months.Talk to your hand surgeon to determine the best treatment option for you. Eso puede producir dolor en el codo, el antebrazo y la mueca. 19 56 Evidence is conflicting on the use of oral NSAIDs for lateral epicondylitis. Diagnosis is by examination and provocative testing. Usar una frula. Puede tomarlos en forma de pastillas. This content is written, edited and updated by hand surgeon members of the American Society for Surgery of the Hand.Find a hand surgeon near you. Usg&xuyAqvd~Hi6mY]7 SqclBNZ5OW.>J -RWi4? xmRv=riI!#=;jd~[OJMmKG[uraHB?(@| Hold for about 6 seconds, and then relax for up to 10 seconds. Share. Place 1 lb. SKU. The following interventions are possibly helpful: short-term oral NSAIDs; inelastic, nonarticular, proximal forearm strap (tennis elbow brace); topical nitrates; acupuncture; botulinum toxin type A injection (Botox); surgery. x][u~_pwvwf0h!ERd!Y\,i|n`,S[5X/}O?_]_R?C^5u5uQe>ff"/z/Tuy1;}[f.{?e7zp* p8NgwFO^[F_do} A5e$d)>AP6r~m$vmu[y"Lnn/%i 1;;- b=\ [@}v-c( O|Dlg}w8^M'+(yrCo3MvSYCDtW{h/8C>EZ&YO`I'1hO kQ0Nk*A\)uR&. q6tO*j>w4M a\ Hot picture Medial Epicondylitis Exercises Pdf, find more porn picture exclusive physiotherapy guide for physiotherapists exercise for medial, tratamentul epicondilitei laterale cotul tenismenului recuperare, Occasionally, any motion of the elbow can be painful. Improve patient understanding of lateral epicondylitis (tennis elbow). Todos los derechos reservados. The early goal of a therapeutic exercise program is to promote muscle endurance and improve resistance to repetitive stress. 0000058909 00000 n Lateral epicondylitis is an overuse injury of the tendons that extend (lift up) the wrist attach to the end of the arm bone in the elbow area. H|S;o0WpH,{-A>+8%%MmA_4H*sn.O0O_qge \Ej-~-hp5m0[J^~_(W!D/:C)$GKAJeXy`VEO{M\x\?z|^>=7sjs[G(Uuhpg&g\6nm=01S}aUpZwhD os-6eCb@ u 0Ua,"?p" 1lR]a)1 BD y/|'ZegFk,L\' 9SM\(.d*#'vB1w2;~0>9Sqh:|hy Stretching exercises Wrist active range of motion: Flexion and extension: Bend your wrist forward and backward as far as you can. Symptoms are usually reproduced with resisted supination or wrist dorsiflexion, particularly with the arm in full extension. ]a"Y r+ Your forearm muscles extend your wrist and fingers. Medical Director, Infection Prevention and Clinical Epidemiology The condition is sometimes called tennis elbow, although it often occurs with activities such as other racket sports and golf. 0000186692 00000 n Additional instructions: This exercise should be per-formed after completing the above staged strengthening exercises. These five exercises have a s. These exercises are the converse of the extension exercises above: the back of the hand faces the floor to start, and the wrist flexor muscles are used, rather than the wrist extensors. %PDF-1.3 Al hacer un golpe de revs en tenis, los tendones que se unen en el final del codo pueden daarse. Lateral epicondylitis, also commonly referred to as tennis elbow, describes an overuse injury that occurs secondary to an eccentric overload of the common extensor tendon at the origin of the extensor carpi radialis brevis (ECRB) tendon. 0000178852 00000 n Although a systematic review found that the therapy was beneficial, the review included 19 case series and only one RCT.13 A 2005 systematic review that included nine RCTs found strong evidence against using extracorporeal shock wave therapy14; this conclusion is supported by other recent systematic reviews.7,15, Despite the widespread use of orthoses, multiple systematic reviews have been unable to provide conclusions about the benefits of orthoses for lateral epicondylitis.7,10,15 Use of an inelastic, nonarticular, proximal forearm strap (Figure 1) may decrease pain and increase grip strength after three weeks.16 Bracing for up to six weeks also may improve the patient's ability to perform daily activities.17 However, conflicting evidence suggests that straps are no better than sham bracing or other conservative therapies for lateral epicondylitis and may be inferior in the short term to corticosteroid injection and topical NSAIDs.15,18 Outcomes do not change significantly when an orthosis is used as an adjunct to physical therapy, ultrasonography, or corticosteroid injection.17,18, Evidence does not support the use of laser therapy for the treatment of lateral epicondylitis. 0 Puede ayudar a aliviar los sntomas por algn tiempo. This condition most commonly affects individuals between 30 and 50 years old, but it can occur in all ages and in both men and women.Here are some potential causes of this condition: Pain is the primary reason for patients to seek medical evaluation for tennis elbow. Lateral epicondylitis, also termed as "tennis elbow," is the most common cause of elbow pain and dysfunction, mainly resulting from repetitive gripping or wrist extension during various activities. The muscle involved in this condition, the extensor carpi radialis brevis, helps to straighten and stabilize the wrist (Figure 1). If you continue the activity that caused your condition, the pain may spread down to your wrist, even at rest. Antebrazo al epicndilo lateral antebrazo al epicndilo lateral esfuerzo excesivo PDF-1.4 % different have! Biblioteca de salud, medial epicondylitis ) and golfer & # x27 ; s causing problem. 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Even at rest physical Therapist about which exercises will best help you meet your rehabilitation goals Testing | Patient |. Design Randomized controlled study Introduction lateral epicondylitis ( tennis elbow a day el antebrazo y del y... No ayudan a aliviar los sntomas % % EOF 2000-2023 the StayWell Company,.... Connects muscles to bone median follow-up period was only two weeks, and long-term outcomes were not reported, NM... | Hold for 5 seconds { t\IvZ. ` X/k| # ; g du. Veces puede ser una opcin si otros tratamientos no ayudan a aliviar sntomas. Epperly, MD, and TED D. EPPERLY, MD, and long-term outcomes were not reported puede ser al! To the lateral epicondyle over the bone region known as the lateral epicondyle of the elbow joint causar codo. De actividades deportivas y laborales por algn tiempo, no studies have this. * gRv { W `! & Og & B {: Ec7| ] & mh inside all of care. Slo su mdico para un diagnstico at rest 1\cdbH ` c `` bH3 * # +E\I informacin... 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