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DOI: 10.1055/s-0039-3402465
Comparative Study between Scales: Subjective Elbow Value and Patient-rated Tennis Elbow Evaluation Applied to Patients Affected by Lateral Epicondylitis
Article in several languages: português | EnglishAbstract
Objective To verify if the subjective elbow value (SEV) scale presents similar results to those of the Patient-rated Tennis Elbow Evaluation (PRTEE) scale in the evaluation of patients with lateral elbow epicondylitis (LEE).
Methods Thirty-seven patients were diagnosed with LEE in the outpatient service of our hospital through clinical history, physical examination, X-ray, and ultrasonography. The SEV and PRTEE scales were used and their results were compared using a significance level ≥ 5% (p ≥0.05).
Results A statistically significant relationship was found between the values of SEV and PRTEE in the group of patients studied (p = 0.017).
Conclusion Subjective elbow value presented similar results to PRTEE in the evaluation of patients with diagnosis of LEE.
#
Introduction
Lateral elbow epicondylitis (LEE) is an orthopedic condition affecting the tendon of the extensor digitorum communis muscle. It is a very frequent condition, presenting with tendon degeneration and pain in the lateral region of the elbow.[1] The incidence of LEE is roughly 4/1,000 people per year, affecting a wide variety of workers and athletes who perform repetitive elbow and wrist movements. Its peak incidence is from the 4th to the 6th decades of life.[2]
Despite being called “tennis elbow”, LEE affects a large number of workers, ranging from office to industrial production line workers. In a study conducted in Washington, USA, between 1987 and 1995, LEE accounted for 11.7% of work-related injury complaints.[3]
The pathophysiology of LEE is not fully understood. Histopathological changes observed in the tendon include increased fibroblast concentration, vascular hyperplasia, and collagen fiber disorganization; as such, the condition can be defined as an elbow tendinopathy.[2]
Ultrasound (US) is the diagnostic method of choice to confirm LEE diagnosis, associated with physical examination and clinical history findings.[3]
The treatment of LEE remains challenging, with a high rate of poor outcomes.[2] Despite being a relatively common condition, there is little scientific evidence to support an algorithm for LEE treatment.[4] [5] [6]
The evaluation of LEE treatment outcomes is also challenging. There are several scales for elbow function analysis, such as: the Mayo elbow performance score (MEPS), disabilities of the arm, shoulder and hand (DASH) and upper extremity function scale (UEFS). These scales not only evaluate LEE-associated painful symptoms and associated functional loss, but also various trauma-related factors, such as stiffness and instability. As such, score values are increased, generating a false impression of discrete elbow involvement in LEE because the limiting factor for elbow functionality in this condition is pain with preserved range of motion and joint stability.[7] [8] [9] [10]
The Patient-rated Tennis Elbow Evaluation (PRTEE) scale was developed by MacDemid[7] and other authors[8] [9], in 1999, specifically to evaluate LEE cases. In 2005, it was modified to its current model by the same group of researchers. The PRTEE consists of 15 items, which are subdivided into 2 parts; the 1st part contains 5 items assessing pain, ranging from 0 to 10 according to pain intensity, whereas the second part has 10 items assessing elbow function in daily activities, in which 0 indicates total capacity and 10 refers to total incapacity. Results from the second part are divided by two and added to the results from the first part; the total score ranges from 0, indicating no involvement, to 100 points, referring to the maximum degree of limb involvement by LEE[10] [11]([Figure 1]).
![](https://www.thieme-connect.de/media/10.1055-s-00042410/202005/thumbnails/10-1055-s-0039-3402465-i180063en-1.jpg)
![Zoom Image](/products/assets/desktop/css/img/icon-figure-zoom.png)
Subjective elbow value (SEV) is a single numerical value obtained by asking the patient the percentage of impaired functional activity in the affected elbow that can range from 0 to 100; in which 100 corresponds to an elbow with normal function and 0 to an elbow with total inability to perform daily routine and professional activities.[11]
The present study intended to verify if the SEV scale presented similar results to those of the PRTEE scale for the evaluation of patients with untreated LEE.
#
Materials and Methods
This study was conducted from July 2016 to March 2017. In total, 53 patients were evaluated at the shoulder and elbow outpatient facility with a diagnostic hypothesis of LEE; 37 subjects met the inclusion and exclusion criteria for this study ([Table 1]).
PATIENTS |
AGE |
GENDER |
OCCUPATION |
AFFECTED SIDE |
ROM |
COZEN/MILLS/ GARDNER |
PRTEE |
SEV |
---|---|---|---|---|---|---|---|---|
(F/E; P/S)* |
||||||||
01 |
52 |
Female |
HOUSEMAID |
RIGHT |
0-140; 75-80 |
POS/POS/POS |
80 |
30% |
02 |
56 |
Male |
RETIRED |
LEFT |
0-140; 75-80 |
POS/POS/POS |
77 |
20% |
03 |
66 |
Male |
COMMERCIAL REPRESENTATIVE |
RIGHT |
0-140; 90-90 |
POS/POS/NEG |
60 |
30% |
04 |
48 |
Female |
HOUSEMAID |
RIGHT |
5-140; 75-85 |
POS/POS/NEG |
63 |
50% |
05 |
53 |
Female |
TEACHER |
RIGHT |
0-130; 70-80 |
POS/POS/POS |
74 |
40% |
06 |
50 |
Female |
HAIRDRESSER |
RIGHT |
0-120; 65-80 |
POS/POS/NEG |
87 |
30% |
07 |
46 |
Female |
CLEANING ATTENDANT |
RIGHT |
0-140; 75-80 |
POS/POS/NEG |
93 |
50% |
08 |
49 |
Female |
CLEANING ATTENDANT |
RIGHT |
0-120; 70-80 |
POS/POS/POS |
75 |
45% |
09 |
51 |
Female |
UNEMPLOYED |
RIGHT |
0-130; 65-75 |
POS/POS/POS |
76 |
30% |
10 |
44 |
Female |
HOUSEMAID |
RIGHT |
0-120; 60-80 |
POS/POS/NEG |
77 |
60% |
11 |
48 |
Female |
RADIOLOGY TECHNICIAN |
RIGHT |
0-140; 70-85 |
POS/NEG/NEG |
68 |
70% |
12 |
57 |
Male |
TEACHER |
RIGHT |
0-120; 75-80 |
POS/POS/NEG |
69 |
50% |
13 |
45 |
Female |
MANICURIST |
RIGHT |
0-130; 70-85 |
POS/POS/NEG |
74 |
30% |
14 |
49 |
Female |
FINANCIAL EXECUTIVE |
RIGHT |
0-140; 75-85 |
POS/POS/POS |
85 |
90% |
15 |
59 |
Male |
TAXI DRIVER |
RIGHT |
0-140;90-90 |
NEG/POS/POS |
73 |
60% |
16 |
55 |
Male |
LAWYER |
RIGHT |
0-140;90-90 |
POS/POS/POS |
66 |
30% |
17 |
60 |
Female |
HOUSEKEEPER |
RIGHT |
0-140;90-90 |
POS/POS/POS |
72 |
30% |
18 |
40 |
Female |
ELDERLY CAREGIVER |
RIGHT |
0-140;90-90 |
NEG/NEG/POS |
71 |
25% |
19 |
51 |
Male |
HAIRDRESSER |
LEFT |
0-140;80-80 |
NEG/NEG/POS |
74 |
50% |
20 |
43 |
Male |
DOORMAN |
RIGHT |
0-130;80-80 |
POS/POS/POS |
73 |
70% |
21 |
39 |
Female |
SEAMSTRESS |
RIGHT |
0-140;90-90 |
POS/POS/POS |
78 |
35% |
22 |
44 |
Female |
HOUSEMAID |
RIGHT |
0-140;90-90 |
POS/POS/POS |
70 |
55% |
23 |
45 |
Male |
DRIVER |
LEFT |
0-140;90-90 |
POS/POS/POS |
60 |
45% |
24 |
46 |
Female |
CLEANING ATTENDANT |
LEFT |
0-140; 80-90 |
POS/NEG/POS |
75 |
40% |
25 |
56 |
Male |
TEACHER |
RIGHT |
0-130; 75-80 |
POS/POS/POS |
68 |
30% |
26 |
42 |
Female |
RADIOLOGY TECHNICIAN |
LEFT |
0-140; 80-90 |
POS/POS/NEG |
62 |
50% |
27 |
54 |
Female |
NURSE ASSISTANT |
LEFT |
0-140; 90-90 |
POS/NEG/NEG |
60 |
50% |
28 |
45 |
Male |
RETIRED |
RIGHT |
0-140; 80-90 |
POS/POS/NEG |
65 |
30% |
29 |
33 |
Female |
HAIRDRESSER |
RIGHT |
0-130;80-80 |
POS/POS/POS |
81 |
70% |
30 |
47 |
Female |
HOUSEMAID |
RIGHT |
0-140;80-90 |
POS/POS/POS |
63 |
60% |
31 |
45 |
Female |
COMMERCIAL REPRESENTATIVE |
RIGHT |
0-140;90-90 |
POS/POS/POS |
76 |
80% |
32 |
40 |
Female |
HOUSEKEEPER |
RIGHT |
0-140;90-90 |
POS/POS/POS |
70 |
60% |
33 |
54 |
Female |
HAIRDRESSER |
RIGHT |
0-140;90-90 |
NEG/POS/POS |
82 |
80% |
34 |
37 |
Female |
HAIRDRESSER |
RIGHT |
0-140;90-90 |
NEG/NEG/POS |
60 |
80% |
35 |
47 |
Female |
LAUNDRY WORKER |
RIGHT |
0-130;80-80 |
POS/POS/POS |
66 |
60% |
36 |
36 |
Male |
BRICKLAYER ASSISTANT |
LEFT |
0-130;90-90 |
POS/POS/POS |
67 |
70% |
37 |
38 |
Male |
MECHANIC |
RIGHT |
0-140;90-90 |
POS/NEG/NEG |
68 |
60% |
The inclusion criteria were: compatible findings at clinical history and physical examination, complemented by ultrasound findings, normal results at elbow radiographs, and lack of any previous treatment.
Clinical criteria used for diagnosis included chronic pain at the lateral aspect of the elbow, defined as pain for more than 12 weeks, pain during lateral epicondyle palpation and positivity in at least two of the following physical examination tests: pain during wrist or finger extension against resistance with the elbow at 90 degrees of flexion (Cozen test),[12] pain with the elbow in extension and passive wrist extension (Mills test),[12] pain during elevation from chair with pronated and semiflexed wrist (Gardner test),[12] pain at resistive supination,[12] and pain during passive stretch of the supinator muscle[12] ([Figure 2A-B]). All photos belong to the authors' archives and pictures of all physical examination tests would exceed the maximum number of pictures allowed by this journal.
![](https://www.thieme-connect.de/media/10.1055-s-00042410/202005/thumbnails/10-1055-s-0039-3402465-i180063en-2.jpg)
![Zoom Image](/products/assets/desktop/css/img/icon-figure-zoom.png)
The exclusion criteria were: previous history of rheumatologic disease and/or arthritis, orthopedic disorders affecting the elbow other than LEE, acute elbow pain, diabetes mellitus, pregnancy, neurological diseases, peripheral neuropathies, recent acute upper limb trauma, previous surgery on the affected limb, and chronic polyarthralgia.
The clinical diagnosis was made and then confirmed by an ultrasound examination; an x-ray of the affected elbow was also performed to exclude other orthopedic joint conditions.[11]
The research project was duly approved by the research ethics committee of the institution. All patients participating in this study signed an informed consent form.
The 37 patients diagnosed with lateral epicondylitis were evaluated using the PRTEE and SEV scales during an outpatient visit at our hospital.[8] [9] [10] [11]
An Excel spreadsheet (Microsoft Corp., Redmond, WA, USA) was used for data organization. The IBM SPSS statistical package, version 23.0 (IBM Corp., Armonk, NY, USA) was used for results analysis. The Mann-Whitney test was used to verify possible differences between genders and to analyze the relationship between laterality and SEV.
The Spearman's correlation analysis was used to evaluate the degree of relationship between SEV and PRTEE. Values were considered statistically significant when p- value was greater than or equal to 5% (p ≥0.05).
#
Results
In total, 25 patients were female (67.6%); the mean patients' age was 47 years, 10 months-old, and 27 (79.4%) subjects performed activities associated with repetitive elbow or wrist movements. At the physical examination tests, 86.4%, 81%, and 67.5% of the patients presented positive results at the Cozen, Mills, and Gardner tests, respectively.
The Mann-Whitney test was used to evaluate whether gender and laterality represented important factors in SEV results and found no statistically significant differences. Therefore, the fact that the patient affected by LEE was male or female did not influence the degree of elbow involvement (p = 0.179); similarly, whether the affected side was the right or left one did not represent a statistically significant factor (p = 0.433) ([Table 2]).
Variable |
Gender |
n |
Average |
Standard deviation |
Minimum |
Maximum |
25th percentile |
50th percentile (Median) |
75th percentile |
Significance (p) |
---|---|---|---|---|---|---|---|---|---|---|
SEV |
Female |
25 |
54.80% |
18.62% |
30.00% |
100.00% |
40.00% |
50.00% |
70.00% |
0.179 |
Male |
12 |
45.42% |
17.25% |
20.00% |
70.00% |
30.00% |
47.50% |
60.00% |
||
Total |
37 |
51.76% |
18.49% |
20.00% |
100.00% |
32.50% |
50.00% |
65.00% |
Variable |
Gender |
n |
Average |
Standard deviation |
Minimum |
Maximum |
25th percentile |
50th percentile (Median) |
75th percentile |
Significance (p) |
---|---|---|---|---|---|---|---|---|---|---|
SEV |
Right |
30 |
53.00% |
19.24% |
30.00% |
100.00% |
30.00% |
52.50% |
70.00% |
0.1433 |
Left |
7 |
46.43% |
14.92% |
20.00% |
70.00% |
40.00% |
50.00% |
50.00% |
||
Total |
37 |
51.76% |
18.49% |
20.00% |
100.00% |
32.50% |
50.00% |
65.00% |
The Spearman correlation analysis evaluated if there was a statistically significant relationship between the results obtained with the SEV and PRTEE scales; since this relationship actually existed, results were equivalent when both scales were applied (p = 0.017) ([Table 3]).
Variable |
Statistical Analysis |
SEV |
---|---|---|
AGE |
Coefficient of correlation (r) |
-0.409 |
Calculated significance (p) |
0.012 |
|
n |
37 |
|
PRTEE |
Coefficient of correlation (r) |
+0.391 |
Calculated significance (p) |
0.017 |
|
n |
37 |
#
Discussion
Previous researches have shown that the PRTEE scale is a satisfactory method for evaluating LEE patients, since it was created specifically for the study of these subjects. The PRTEE scale presents a good correlation with clinical complaints in subjects with LEE-associated functional limitations.[7] [13] In several case series, the PRTEE scale demonstrated a good sensitivity in the evaluation of LEE patients, but it is very extensive and difficult for the examiner to memorize; these are its main limitations for its use in clinical practice. The PRTEE had good sensitivity and specificity in the evaluation of both acute and chronic LEE cases.[7] [13] [14]
Consistent with the literature, our study also demonstrated that SEV is a simple and easy-to-use scale for the clinical investigation of the degree of functional impairment in patients with elbow conditions, being easily understood by the subject and rapidly memorized by the physician. In addition, SEV was developed to evaluate any elbow condition.[15]
A study conducted in 2014 observed that there was a moderate statistical relationship between SEV and MEPS in the evaluation of patients with elbow tendon conditions; this paper showed that, despite being simple, SEV is as good as a more complex scale, such as MEPS, in evaluating these diseases.[16]
In 2017, Ernstbrunner observed similar results in the postoperative evaluation of patients undergoing total elbow arthroplasty using MEPS or SEV scales.[17]
A 2011 study demonstrated similar results between SEV and MEPS in the evaluation of patients submitted to an anconeus graft at the elbow for chronic posterior skin defect with no joint involvement; this finding confirmed information from the previous study that SEV is a very appropriate scale for elbow conditions.[18]
Our study observed a statistically significant relationship between results obtained with the SEV and PRTEE scales in the evaluation of patients diagnosed with LEE.
#
Conclusion
Subjective elbow value is a functional scale with statistically similar results to those of PRTEE in the evaluation of untreated LEE patients.
#
#
Conflitos de Interesse
Os autores declaram não haver conflitos de interesse.
-
Referências
- 1 Potter HG, Hannafin JA, Morwessel RM, DiCarlo EF, O'Brien SJ, Altchek DW. Lateral epicondylitis: correlation of MR imaging, surgical, and histopathologic findings. Radiology 1995; 196 (01) 43-46
- 2 Matache BA, Berdusco R, Momoli F, Lapner PL, Pollock JW. A randomized, double-blind sham-controlled trial on the efficacy of arthroscopic tennis elbow release for the management of chronic lateral epicondylitis. BMC Musculoskelet Disord 2016; 17 (01) 239
- 3 Connell D, Burke F, Coombes P. et al. Sonographic examination of lateral epicondylitis. AJR Am J Roentgenol 2001; 176 (03) 777-782
- 4 Labelle H, Guibert R, Joncas J, Newman N, Fallaha M, Rivard CH. Lack of scientific evidence for the treatment of lateral epicondylitis of the elbow. An attempted meta-analysis. J Bone Joint Surg Br 1992; 74 (05) 646-651
- 5 Smidt N, Assendelft WJ, Arola H. et al. Effectiveness of physiotherapy for lateral epicondylitis: a systematic review. Ann Med 2003; 35 (01) 51-62
- 6 Nilsson P, Baigi A, Marklund B, Månsson J. Cross-cultural adaptation and determination of the reliability and validity of PRTEE-S (Patientskattad Utvärdering av Tennisarmbåge), a questionnaire for patients with lateral epicondylalgia, in a Swedish population. BMC Musculoskelet Disord 2008; 9 (01) 79
- 7 Macdermid J. Update: the patient-rated forearm evaluation questionnaire is now the patient-rated tennis elbow evaluation. J Hand Ther 2005; 18 (04) 407-410
- 8 Rompe JD, Overend TJ, MacDermid JC. Validation of the patient-rated tennis elbow evaluation questionnaire. J Hand Ther 2007; 20 (01) 3-10 , quiz 11
- 9 Sousa de Andrade C, Costa Souza R, Rosane Chamlian T. et al. Tradução e adaptação cultural do questionário PRTEE (Patient-rated Tennis Elbow Evaluation) para a língua portuguesa. Cad Ter Ocup UFSCar 2011; 19 (03) 281-288
- 10 Newcomer KL, Martinez-Silvestrini JA, Schaefer MP, Gay RE, Arendt KW. Sensitivity of the Patient-rated Forearm Evaluation Questionnaire in lateral epicondylitis. J Hand Ther 2005; 18 (04) 400-406
- 11 Taylor SA, Hannafin JA. Evaluation and management of elbow tendinopathy. Sports Health 2012; 4 (05) 384-393
- 12 Levin D, Nazarian LN, Miller TT. et al. Lateral epicondylitis of the elbow: US findings. Radiology 2005; 237 (01) 230-234
- 13 Plancher KD, Halbrecht J, Lourie GM. Medial and lateral epicondylitis in the athlete. Clin Sports Med 1996; 15 (02) 283-305
- 14 Overend TJ, Wuori-Fearn JL, Kramer JF, MacDermid JC. Reliability of a patient-rated forearm evaluation questionnaire for patients with lateral epicondylitis. J Hand Ther 1999; 12 (01) 31-37
- 15 Sathyamoorthy P, Kemp GJ, Rawal A, Rayner V, Frostick SP. Development and validation of an elbow score. Rheumatology (Oxford) 2004; 43 (11) 1434-1440
- 16 Schneeberger AG, Kösters MC, Steens W. Comparison of the subjective elbow value and the Mayo elbow performance score. J Shoulder Elbow Surg 2014; 23 (03) 308-312
- 17 Ernstbrunner L, Hingsammer A, Imam MA. et al. Long-term results of total elbow arthroplasty in patients with hemophilia. J Shoulder Elbow Surg 2018; 27 (01) 126-132
- 18 Elhassan B, Karabekmez F, Hsu CC, Steinmann S, Moran S. Outcome of local anconeus flap transfer to cover soft tissue defects over the posterior aspect of the elbow. J Shoulder Elbow Surg 2011; 20 (05) 807-812
Endereço para correspondência
Publication History
Received: 01 February 2018
Accepted: 28 March 2019
Article published online:
20 October 2020
© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revinter Publicações Ltda
Rio de Janeiro, Brazil
-
Referências
- 1 Potter HG, Hannafin JA, Morwessel RM, DiCarlo EF, O'Brien SJ, Altchek DW. Lateral epicondylitis: correlation of MR imaging, surgical, and histopathologic findings. Radiology 1995; 196 (01) 43-46
- 2 Matache BA, Berdusco R, Momoli F, Lapner PL, Pollock JW. A randomized, double-blind sham-controlled trial on the efficacy of arthroscopic tennis elbow release for the management of chronic lateral epicondylitis. BMC Musculoskelet Disord 2016; 17 (01) 239
- 3 Connell D, Burke F, Coombes P. et al. Sonographic examination of lateral epicondylitis. AJR Am J Roentgenol 2001; 176 (03) 777-782
- 4 Labelle H, Guibert R, Joncas J, Newman N, Fallaha M, Rivard CH. Lack of scientific evidence for the treatment of lateral epicondylitis of the elbow. An attempted meta-analysis. J Bone Joint Surg Br 1992; 74 (05) 646-651
- 5 Smidt N, Assendelft WJ, Arola H. et al. Effectiveness of physiotherapy for lateral epicondylitis: a systematic review. Ann Med 2003; 35 (01) 51-62
- 6 Nilsson P, Baigi A, Marklund B, Månsson J. Cross-cultural adaptation and determination of the reliability and validity of PRTEE-S (Patientskattad Utvärdering av Tennisarmbåge), a questionnaire for patients with lateral epicondylalgia, in a Swedish population. BMC Musculoskelet Disord 2008; 9 (01) 79
- 7 Macdermid J. Update: the patient-rated forearm evaluation questionnaire is now the patient-rated tennis elbow evaluation. J Hand Ther 2005; 18 (04) 407-410
- 8 Rompe JD, Overend TJ, MacDermid JC. Validation of the patient-rated tennis elbow evaluation questionnaire. J Hand Ther 2007; 20 (01) 3-10 , quiz 11
- 9 Sousa de Andrade C, Costa Souza R, Rosane Chamlian T. et al. Tradução e adaptação cultural do questionário PRTEE (Patient-rated Tennis Elbow Evaluation) para a língua portuguesa. Cad Ter Ocup UFSCar 2011; 19 (03) 281-288
- 10 Newcomer KL, Martinez-Silvestrini JA, Schaefer MP, Gay RE, Arendt KW. Sensitivity of the Patient-rated Forearm Evaluation Questionnaire in lateral epicondylitis. J Hand Ther 2005; 18 (04) 400-406
- 11 Taylor SA, Hannafin JA. Evaluation and management of elbow tendinopathy. Sports Health 2012; 4 (05) 384-393
- 12 Levin D, Nazarian LN, Miller TT. et al. Lateral epicondylitis of the elbow: US findings. Radiology 2005; 237 (01) 230-234
- 13 Plancher KD, Halbrecht J, Lourie GM. Medial and lateral epicondylitis in the athlete. Clin Sports Med 1996; 15 (02) 283-305
- 14 Overend TJ, Wuori-Fearn JL, Kramer JF, MacDermid JC. Reliability of a patient-rated forearm evaluation questionnaire for patients with lateral epicondylitis. J Hand Ther 1999; 12 (01) 31-37
- 15 Sathyamoorthy P, Kemp GJ, Rawal A, Rayner V, Frostick SP. Development and validation of an elbow score. Rheumatology (Oxford) 2004; 43 (11) 1434-1440
- 16 Schneeberger AG, Kösters MC, Steens W. Comparison of the subjective elbow value and the Mayo elbow performance score. J Shoulder Elbow Surg 2014; 23 (03) 308-312
- 17 Ernstbrunner L, Hingsammer A, Imam MA. et al. Long-term results of total elbow arthroplasty in patients with hemophilia. J Shoulder Elbow Surg 2018; 27 (01) 126-132
- 18 Elhassan B, Karabekmez F, Hsu CC, Steinmann S, Moran S. Outcome of local anconeus flap transfer to cover soft tissue defects over the posterior aspect of the elbow. J Shoulder Elbow Surg 2011; 20 (05) 807-812
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