ABSTRACT
Introdução: As úlceras no pé diabético surgem da interação complexa entreneuropatia periférica e doença arterial periférica, comprometendo a cicatrização após traumas. Objetivo: Explorar a diversidade de intervenções terapêuticas não farmacológicas que têm sido estudadas e avaliadas quanto à sua eficácia e segurança no tratamento de úlceras no pé diabético. Metodologia: Pesquisa do tipo revisão integrativa da literatura. Para obtenção dos resultados foi realizado um levantamento nas plataformas PubMed e Biblioteca Virtual em Saúde. Para elaboração dos resultados foram selecionados 21 artigos. Resultados: As intervenções encontradas foram oxigenoterapia hiperbárica, terapia de feridas por pressão negativa, uso de matriz dérmica, plasma rico em plaquetas, plasma atmosférico frio, tratamentos com curativos especiais e uso de solas rígidas, entre outros. Mostraram uma variabilidade na taxa de cicatrização e no tempo de fechamento da ferida, bem como na melhoria da regeneração tecidual. Conclusão: As pesquisas mostram uma diversidade de intervenções terapêuticas não farmacológicas utilizadas no tratamento de úlceras no pé diabético, ressaltando a necessidade de abordagens individualizadas e mais estudos para determinar a eficácia e segurança de cada intervenção (AU).
Introduction:Diabetic foot ulcers arise from the complex interaction between peripheral neuropathy and peripheral arterial disease, compromising wound healing after traumas. Objective:To explore the diversity of non-pharmacological therapeutic interventions that have been studied and evaluated for their effectiveness and safety in the treatment of diabetic foot ulcers. Methodology: An integrative literature review was conducted. The search for results was performed on the PubMed and Virtual Health Library platforms. Twenty-one articles were selected for result elaboration.Results:The identified interventions included hyperbaric oxygen therapy, negative pressure wound therapy, use of dermal matrix, platelet-rich plasma, cold atmospheric plasma, treatments with special dressings, and the use of rigid soles, among others. They exhibited variability in the healing rate and wound closure time, as well as improvement in tissue regeneration.Conclusion:The research demonstrates a diversity of non-pharmacological therapeutic interventions used in the treatment of diabetic foot ulcers, emphasizing the need for individualized approaches and further studies to determine the effectiveness and safety of each intervention (AU).
Introducción: Las úlceras en el pie diabético surgen de la interacción compleja entre neuropatía periférica y enfermedad arterial periférica, comprometiendo la cicatrización después de traumas.Objetivo: Explorar la diversidad de intervenciones terapéuticas no farmacológicas que han sido estudiadas y evaluadas en cuanto a su eficacia y seguridad en el tratamiento de úlceras en el pie diabético.Metodología: Investigación del tipo revisión integrativa de la literatura. Para obtener los resultados se realizó un estudio en las plataformas PubMed y Biblioteca Virtual en Salud. Para la elaboración de los resultados se seleccionaron 21 artículos. Resultados: Las intervenciones encontradas fueron oxigenoterapia hiperbárica, terapia de heridas por presión negativa, uso de matriz dérmica, plasma rico en plaquetas, plasma atmosférico frío, tratamientos con curativos especiales y uso de suelas rígidas, entre otros. Mostraron una variabilidad en la tasa de cicatrización y en el tiempo de cierre de la herida, así como en la mejora de la regeneración tisular. Conclusión: Las investigaciones muestran una diversidad de intervenciones terapéuticas no farmacológicas utilizadas en el tratamiento de úlceras en el pie diabético, resaltando la necesidad de enfoques individualizados y más estudios para determinar la eficacia y seguridad de cada intervención (AU).
Subject(s)
Humans , Evaluation of Results of Therapeutic Interventions , Diabetic Foot/pathology , Healthcare Models , Pressure Ulcer/pathology , Peripheral Arterial DiseaseABSTRACT
Introducción: El dolor de espalda es un síntoma frecuente y de distribución universal que afecta a personas de cualquier edad y de ambos sexos. El 80 % de la población presentará un dolor de espalda en algún momento de su vida. Los procesos agudos son autolimitados y se resuelven en el plazo de unas semanas, excepto algunos casos que se cronifican y requieren asistencia médica continuada. Los cuadros crónicos son más frecuentes en edades comprendidas entre 45 y 65 años y en el sexo femenino. Objetivo: Actualizar los elementos generales relacionados con el diagnóstico y tratamiento del dolor de espalda. Métodos: Se realizó una revisión detallada en la literatura en relación al dolor de espalda en cuanto a su diagnóstico y tratamiento. Se obtuvo literatura actualizada en las bases de datos Cumed, Ibec, Lilac, Pubmed/Medline, Scopus y Wholis. Se hizo una revisión del tema fundamentalmente de los últimos 5 años. Conclusiones: El dolor de espalda es un síntoma frecuente y de distribución universal que afecta a personas de cualquier edad y de ambos sexos. Las recomendaciones presentadas están basadas en la mejor evidencia disponible, con la intención de estandarizarlas para el tratamiento del dolor de espalda en la Atención Primaria de Salud y para el tratamiento farmacológico y no farmacológico(AU)
Introduction: Back pain is a frequent and universally distributed symptom that affects people of any age and of both sexes. 80% of the population will experience back pain at some point in their lives. Acute processes are self-limiting and resolve within a few weeks, except for some cases that become chronic and require continued medical care. Chronic symptoms are more frequent in ages between 45 and 65 years and in the female sex. Objective: To update the general elements related to the diagnosis and treatment of back pain. Methods: A detailed review of the literature was carried out in relation to back pain in terms of diagnosis and treatment. Updated literature was retrieved from Cumed, Ibec, Lilac, Pubmed/Medline, Scopus, and Wholis databases. A review of the subject was made fundamentally of the last 5 years. Conclusions: Back pain is a frequent and universally distributed symptom that affects persons of any age and both sexes. The recommendations are based on the best available evidence, with the intention of standardizing them for treating back pain in Primary Health Care and for pharmacological and non-pharmacological treatment(AU)
Subject(s)
Humans , Male , Female , Back/anatomy & histology , Back Pain/diagnosis , Back Pain/drug therapy , Back Pain/diagnostic imaging , Exercise Movement Techniques/methodsABSTRACT
RESUMEN Introducción: Las vacunas contra la COVID-19 estimulan procesos inmunitarios que permiten mitigar el SARS-CoV-2, que afectó a gran parte de la población. Las investigaciones de las reacciones adversas presentadas por las vacunas de la COVID-19 deben ser continuas, ya que en la actualidad no existe información suficiente sobre sus consecuencias. Objetivo: Determinar las posibles reacciones adversas en adultos jóvenes y mayores pertenecientes al Recinto Umpechico inoculados contra el SARS-CoV-2 en Santo Domingo, durante el transcurso de 2021. Método: Se elaboró un estudio descriptivo en una población de 600 moradores de dicha localidad inoculados contra el SARS-CoV-2. Se empleó un muestreo no probabilístico por conveniencia cuya muestra fue de 235 habitantes. Las variables del estudio fueron: reacciones adversas de las vacunas contra la COVID-19, nombre de la vacuna recibida, número de dosis, intensidad y tiempo de duración de los síntomas, medicamentos utilizados para mitigar dichas reacciones adversas. Resultados: El 31,5 % de los encuestados que presentaron síntomas fueron de género masculino. La vacuna más aplicada fue Pfizer con 47,65 %, con un porcentaje de síntomas del 29,36 %. La reacción adversa más presentada fue dolor de brazo con un 31,98 %, con duración de dos a tres días equivalentes al 48,96 %; el 62,65 % usó paracetamol y el 20,5 % baños de agua fría para disminuir los síntomas. Conclusiones: Las vacunas fabricadas por las distintas casas farmacéuticas provocan reacciones adversas que van desde leves a graves, manifestándose a cualquier edad y a un corto o a largo plazo de duración, las cuales en la mayoría de los casos son fácilmente tratadas con medicamentos farmacológicos y no farmacológicos.
ABSTRACT Introduction: COVID-19 vaccines stimulate immune processes that allow SARS-CoV-2, which affected a large part of the population, to be mitigated. The research on the adverse reactions presented by the COVID-19 vaccines must be continuous, since at present there is not enough information on their consequences. Objective: To determine the possible adverse reactions in young and older adults belonging to the Recinto Umpechico, inoculated against SARS-CoV-2 in Santo Domingo, during 2021. Method: A descriptive study was carried out in a population of 600 residents of said locality, inoculated against SARS-CoV-2. Non-probability convenience sampling was used, with a sample of 235 inhabitants. The study variables were: adverse reactions to COVID-19 vaccines, name of the vaccine received, number of doses, intensity and duration of symptoms, medications used to mitigate said adverse reactions. Results: 31.5% of the respondents who presented symptoms were male. The most common vaccine was Pfizer with 47.65%, with a percentage of symptoms of 29.36%. The most common adverse reaction was arm pain with 31.98%, lasting two to three days, equivalent to 48.96%; 62.65% used paracetamol and 20.5% used cold water baths to reduce symptoms. Conclusions: The vaccines manufactured by the different pharmaceutical companies cause adverse reactions that range from mild to severe, manifesting at any age and for a short or long term, which in most cases are easily treated with pharmacological and non-pharmacological medications.
RESUMO Introdução: As vacinas COVID-19 estimulam processos imunológicos que permitem mitigar o SARS-CoV-2, que afetou grande parte da população. As investigações das reações adversas apresentadas pelas vacinas COVID-19 devem ser contínuas, pois atualmente não há informações suficientes sobre suas consequências. Objetivo: Determinar as possíveis reações adversas em adultos jovens e idosos pertencentes ao Campus Umpechico inoculados contra SARS-CoV-2, em Santo Domingo, durante o ano de 2021. Método: Estudo descritivo realizado em uma população de 600 moradores da referida localidade inoculada contra SARS-CoV-2. Foi utilizada uma amostragem não probabilística de conveniência, cuja amostra foi de 235 habitantes. As variáveis do estudo foram: reações adversas das vacinas COVID-19, nome da vacina recebida, número de doses, intensidade e duração dos sintomas, medicamentos utilizados para mitigar tais reações adversas. Resultados: 31,5% dos entrevistados que apresentaram sintomas eram do sexo masculino. A vacina mais aplicada foi a Pfizer com 47,65%, com percentual de sintomas de 29,36%. A reação adversa mais comum foi dor no braço com 31,98%, com duração de dois a três dias, equivalente a 48,96%; 62,65% usaram paracetamol e 20,5% usaram banhos de água fria para reduzir os síntomas. Conclusões: As vacinas fabricadas pelas diferentes empresas farmacêuticas causam reações adversas que variam de leves a graves, manifestando-se em qualquer idade e de curto ou longo prazo, que na maioria dos casos são facilmente tratadas com medicamentos farmacológicos e não farmacológicos.
ABSTRACT
La sarcopenia es un síndrome geriátrico caracterizado por la pérdida generalizada y progresiva de la masa muscular esquelética, así como disminución de la fuerza muscular y del rendimiento físico. Al respecto, el tratamiento no farmacológico es de gran importancia por su acción en la musculatura esquelética. En este trabajo se precisan los elementos fundamentales para aplicar esta terapia en ancianos, cuya evaluación clínica incluye, entre otros, la valoración de comorbilidades crónicas y agudas y de su funcionalidad física mediante el índice de Katz y la escala de Lawton y Brody, el volumen de actividad física planificada y el diagnóstico de los estadios de sarcopenia por el estado de la masa muscular esquelética, según el European Working Group on Sarcopenia in Older People. También se proponen programas de ejercicios de fuerza y resistencia corroborados en metaanálisis, con una duración, frecuencia e intensidad establecidas, para fortalecer la musculatura esquelética y su acción sobre los cambios fisiopatológicos, a fin de lograr la adaptación muscular y mejorar la funcionalidad física; con ello, se previenen las caídas y fracturas en los ancianos con sarcopenia y se mejora su calidad de vida.
Sarcopenia is a geriatric syndrome characterized by the widespread and progressive loss of the skeletal muscular mass and decrease of the muscular force and physical performance. In this respect, the non-pharmacological treatment is of great importance due to its action in the skeletal musculature. In this work the fundamental elements to apply this therapy in elderly are specified whose clinical evaluation includes, among others, the valuation of chronic and acute comorbidities and of their physical functionality by means of the Katz index and the Lawton and Brody scale, the volume of planned physical activity and the diagnosis of the sarcopenia phases by the condition of the skeletal muscular mass, according to the European Working Group on Sarcopenia in Older People. Programs of force and resistance exercises corroborated in meta-analysis are also suggested, with an established duration, frequency and intensity, to strengthen the skeletal musculature and its action on the pathophysiological changes, in order to achieve the muscular adaptation and improve the physical functionality; with it, falls and fractures are prevented in the elderly with sarcopenia and improve their life quality.
Subject(s)
Exercise , Sarcopenia , Quality of Life , AgedABSTRACT
Buscou-se relatar a experiência de um profissional de educação física no desenvolvimento de Projetos Terapêuticos Singulares (PTS) utilizados no acompanhamento de usuários em sofrimento mental de um CAPSad da região metropolitana Fortaleza-CE. Trata-se de uma pesquisa do tipo relato de experiência com abordagem qualitativa realizada de janeiro de 2021 a fevereiro de 2022. Os resultados indicam que a participação do profissional de educação física residente foi de grande importância desde o planejamento do PTS junto às equipes multidisciplinares aos acompanhamentos individuais e/ou coletivos dos usuários e seus familiares no contexto de recuperação. O cuidado integral e participativo contribuiu no desenvolvimento da autonomia dos sujeitos rumo à responsabilização do próprio cuidado.
It was sought to report the experience of a physical education professional in the development of Singular Therapeutic Projects (PTS) used in the follow-up of users in mental suffering of a CAPSad in the metropolitan region of Fortaleza-CE. This is an experience report type research with a qualitative approach carried out from January 2021 to February 2022. The results indicate that the participation of the resident physical education professional was of great importance from the planning of the PTS with the multidisciplinary teams to the individual and/or collective follow-ups of users and their families in the context of recovery. Comprehensive and participatory care contributed to the development of subjects' autonomy towards accountability for their own care.
Buscamos relatar la experiencia de un profesional de educación física en el desarollo de Proyectos Terapéuticos Singulares (PTS) utilizados en el acompañamiento de usuarios en sufrimiento psíquico de un CAPSad en la región metropolitana de Fortaleza-CE. Se trata de una investigación tipo relato de experiencia con abordaje cualitativo realizada de enero de 2021 a febrero de 2022. Los resultados indican que la participación del profesional residente de educación física fue de gran importancia desde la planificación del PTS con los equipos multidisciplinarios hasta el individual y /o seguimientos colectivos de usuarios y sus familias en el contexto de la recuperación. El cuidado integral y participativo contribuyó al desarrollo de la autonomía de los sujetos hacia la responsabilidad por su propio cuidado.
ABSTRACT
Refractory tic disorders (RTD) are a recently emerging concept gradually formed in pediatric neurology/psychiatry.Currently, the concept and diagnostic criteria of RTD remain unclarified, and it is extremely difficult to treat RTD.In this article, the definition, clinical features, influence factors, diagnosis, differential diagnosis, pharmacological treatment and non-pharmacological treatment of RTD in children were reviewed.
ABSTRACT
@#Depression in adults is a condition that is treatable by family physicians. The current Clinical Practice Guidelines from the Ministry of Health recommends a selective serotonin reuptake inhibitor (SSRI) as the first-line of pharmacotherapy. Care should be taken to assess the patient’s psychological and social factors contributing to the illness. These factors should be managed by referring the patient to an appropriate allied health professional, such as a psychologist or community based social worker. Specialist referral should be made under certain circumstances (such as treatment-resistance), or if issues pertaining to risk arise. This review aims to give an update on the recently published DSM-5 criteria for diagnosis, and the treatment of the adult patient with depression.
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Although the conventional treatment of heart failure is based on pharmacotherapy, for some children, non-pharmacological treatment can further improve heart function, reduce the incidence of cardiovascular events, improve the quality of life and reduce mortality.Cardiac resynchronization therapy, implantable cardioverter defibrillator, mechanical circulatory support, and heart transplantation expand the thinking and strategies for the treatment of heart failure in children.
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@#Introduction: Chronic musculoskeletal pain is a common disabling condition among older adults with the majority, remain undertreated. This study aimed to determine the uptake of non-pharmacological treatment for chronic musculoskeletal pain among older adults and the associated factors. Methods: A stratified sampling proportionate to size with individual clinics as the strata were used to recruit 276 respondents from six public health clinics in Petaling district, one of the most aged districts in the state of Selangor, Malaysia. Based on the proportion calculated, eligible older adults were selected by systematic random sampling from the registration list. Data was collected using a pre-tested and validated questionnaire through a face-to-face interview with respondents. The questionnaire comprised of seven sections, namely, socio-demographic, comorbidity, depression, pain severity, treatment options, attitude towards chronic pain and chronic musculoskeletal pain. Inferential analysis was conducted using ChiSquare (X2) and Fisher’s Exact Tests. The P value of < 0.05 regarded as statistically significant. Results: A total of 242 (87.7%) of the respondents had chronic musculoskeletal pain, in which 235 (85.1%) were treated with non-pharmacological treatments. The commonly used non-pharmacological treatments were exercise (67.8%), biological-based therapies (40.9%) and massage (33.7%). The uptake of non-pharmacological treatment for chronic musculoskeletal pain among older adults was significantly associated with the presence of diabetes. Conclusion: The findings revealed the remarkably high uptake of non-pharmacological treatment among older adults who experienced chronic musculoskeletal pain which was significantly associated with diabetes and the presence of other diseases like high blood pressure, osteoarthritis, back pain and rheumatic arthritis.
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Resumen En el presente trabajo se analizan los beneficios de un programa grupal de tratamiento no farmacológico realizado por la Asociación Española contra el Cáncer en Galicia (España). Se analizaron 14 ediciones del programa en las que participaron 361 mujeres con cáncer de edades comprendidas entre los 33 y los 82 años. Se adoptó un diseño descriptivo de carácter etnográfico triangulando las técnicas de análisis y las fuentes de recogida de datos por medio de un cuestionario de satisfacción, 32 entrevistas en profundidad y un grupo de discusión con profesionales. Los resultados apoyan la idea de que el programa grupal analizado ha conseguido un elevado grado de satisfacción entre las mujeres participantes en todas las ediciones, ha favorecido la aceptación y el afrontamiento positivo de la enfermedad, aumentado los conocimientos y las habilidades para resolver los problemas relacionados con el proceso, así como promovido las relaciones sociales, la participación en la comunidad y el apoyo social. Desde el punto de vista práctico y profesional, nuestro estudio evidencia la importancia de diseñar e implementar programas grupales desde el ámbito psicosocial y con carácter interdisciplinar que permitan mejorar las estrategias de afrontamiento y el apoyo en poblaciones de mujeres diagnosticadas de cáncer.
Abstract The study aims to determine the benefits of a non-pharmacological treatment and communitarian program carried out by the Spanish Association against Cancer in Galicia (Spain). The total of 14 editions of the program were analyzed in which 361 women with cancer between the ages of 32 and 84 participated. A descriptive ethnographic design was adopted, triangulating the analysis techniques and data collection sources using a satisfaction questionnaire, 32 in-depth interviews and a discussion group with professionals. The results support the idea that the group program analyzed has achieved a high degree of satisfaction among women participating in all editions, has favored the acceptance and positive coping with disease, increased knowledge and skills to solve related problems with the process, as well as promoted social relations, participation in the community and social support. From the practical and professional point of view, our research shows the importance of designing and implementing group programs from the psychosocial and interdisciplinary field that allow improving coping strategies and support in populations of women diagnosed with cancer.
Subject(s)
Humans , Female , Risk Groups , Complementary Therapies , Women's Health , Qualitative Research , NeoplasmsABSTRACT
Keshan disease (KD) is a unique endemic cardiomyopathy of unknown origin in China.According to the state of heart function and the pathogenesis,KD is divided into four types:acute,sub-acute,chronic and latent.Chronic KD comes on slowly,and the clinical manifestation is chronic cardiac insufficiency.Chronic patients often have poor treatment outcomes,with high mortality and disability.This article summarizes the nonpharmacological treatment of heart failure in chronic KD in order to provide a basis for clinical treatment.
ABSTRACT
@#Depression in adults is a condition that is treatable by family physicians. The current Clinical Practice Guidelines from the Ministry of Health recommends a selective serotonin reuptake inhibitor (SSRI) as the first-line of pharmacotherapy. Care should be taken to assess the patient’s psychological and social factors contributing to the illness. These factors should be managed by referring the patient to an appropriate allied health professional, such as a psychologist or community-based social worker. Specialist referral should be made under certain circumstances (such as treatment-resistance), or if issues pertaining to risk arise. This review aims to give an update on the recently published DSM-5 criteria for diagnosis, and the treatment of the adult patient with depression.
ABSTRACT
OBJECTIVES: To assess the effect and safety of transcranial direct-current stimulation (tDCS) in primary chronic insomnia. METHODS: A one-month, double-blind, randomized, sham-controlled trial was performed. A total of 7 patients with primary chronic insomnia received tDCS using anodal (n=3), cathodal (n=2), or sham stimulation (n=2). They were followed up at 1 week and 1 month after treatment. The primary outcome measures included improvement in total sleep time (TST), sleep latency (SL), and sleep efficiency (SE) at 1 month follow-up. RESULTS: TST and SE were improved with tDCS at 1 month follow-up in all patients (100%) of the anodal group, one (50%) of the cathodal group, and one (50%) of the sham group. tDCS improved SL at 1 month follow-up in two patients (67%) of the anodal group, one (50%) of the cathodal group, and none (0%) of the sham group. With respect to adverse events, transient itching sensation occurred in one patient of the anodal group. None of the other groups reported adverse events. CONCLUSIONS: Our results suggest that tDCS may be effective and safe for treatment of primary chronic insomnia. A larger controlled study needs to be further investigated.
Subject(s)
Humans , Follow-Up Studies , Outcome Assessment, Health Care , Pruritus , Sensation , Sleep Initiation and Maintenance Disorders , Transcranial Direct Current StimulationABSTRACT
OBJECTIVES: The present study investigated current practices of insomnia treatment among Korean doctors in clinical settings. METHODS: A total of 100 doctors participated in the present study and filled out a series of survey questions regarding their treatment of insomnia patients. RESULTS: The results revealed that the primary type of insomnia treatment was pharmacological and that the most popular medication was zolpidem. The majority of doctors reported that they also utilized non-pharmacological treatments such as sleep hygiene education and cognitive-behavioral therapy. However, these treatments tended to result in low satisfaction. In addition, the doctors perceived that patients largely preferred pharmacological treatments to non-pharmacological ones and did not have sufficient knowledge of non-pharmacological treatments. CONCLUSION: Many doctors believed that non-pharmacological treatments for insomnia were important, but reported that they were difficult to implement in practice. The results of this study suggest that improved medical conditions for non-pharmacological treatments and education of physicians are necessary to appropriately treat insomnia.
Subject(s)
Humans , Education , Hygiene , Sleep Initiation and Maintenance DisordersABSTRACT
Agitation and delirium are commonly encountered symptoms in palliative care. Based on the clinical features, delirium may present in the hypoactive, hyperactive and mixed forms. By reason of the prevalence, the significant distress and symptom burden, as well as the possibility of reversibility, it is vital that the clinician be vigilant in identifying and treating delirium and its symptoms. This article describes how delirium may present, the clinical features, aetiologies and the methods to screen and diagnose delirium. When managing a delirious patient in the palliative care setting, it is necessary to contextualise any investigation and intervention in terms of the disease condition and trajectory, the level of distress and the care preferences and goals of the patient and family. Non-pharmacological management should always be in place though pharmacological treatments also have a definite role in the relief of distressing symptoms of agitation and delirium. Support and education for the patient, family and care providers are integral and continuous aspects of care for the agitated or delirious terminally ill patient.
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As doenças pulmonares mais prevalentes na atualidade são patologias de característica sistêmica, originadas após acometimento funcional e/ou estrutural de um ou mais pulmões, progredindo para disfunção dos músculos esqueléticos. Isso contribui para a redução da tolerância a atividade física e ao exercício. A Reabilitação Pulmonar é um processo amplo, que requer a combinação de medidas farmacológicas e não farmacológicas e inclui: treinamento físico, educação do paciente, intervenção psicológica e nutricional. Os alvos primários de qualquer Reabilitação Pulmonar são controlar a dispneia e aumentar a capacidade de atividades físicas e exercícios, restaurando a funcionalidade do indivíduo e, consequentemente, sua qualidade de vida. Sendo assim, desenvolvemos este resumo devido à relevância clínica, científica e social do tema. Nos últimos anos, a literatura disponível tem abordado com frequência a prática de testes exequíveis na pratica clínica diária e o avanço do suporte ventilatório como auxiliar na reabilitação pulmonar...
The most prevalent lung diseases today are characteristic of systemic pathologies arising after functional and/or structural involvement of one or more lung, progressing to skeletal muscle dysfunction. This contributes to a reduction in tolerance to physical activity and exercise. Pulmonary Rehabilitation is a comprehensive process that requires a combination of pharmacological and non-pharmacological measures and includes: physical training, patient education, psychological and nutritional intervention. The primary targets of any pulmonary rehabilitation are to control dyspnea and increase the capacity of physical activities and exercises, restoring the individual functionality and consequently their quality of life. Therefore, we developed this summary due to clinical and scientific relevance and social theme.In recent years, the literature has addressed frequently the practice of testing feasible in clinical practice and the advancement of ventilatory support as an aid in pulmonary rehabilitation...
Subject(s)
Humans , Male , Female , Lung Diseases/rehabilitation , Exercise Therapy/methods , Quality of LifeABSTRACT
Insomnia involves difficulty in falling asleep, maintaining sleep or having refreshing sleep. This review gathers the existing informations seeking to explain insomnia, including those that focus on psychological aspects and those considered neurobiological. Insomnia has been defined in psychological (cognitive components, such as worries and rumination, and behavioral aspects, such as classic conditioning) and physiological terms (increased metabolic rate, with increased muscle tone, heart rate and temperature). From the neurobiological point of view, there are two perspectives: one which proposes that insomnia occurs in association with a failure to inhibit wakefulness and another that considers hyperarousal as having an important role in the physiology of sleep. The non-pharmacological interventions developed to face different aspects of insomnia are presented.
Insônia é um transtorno que envolve dificuldade em dormir, em manter-se dormindo ou em ter um sono restaurador. Esta revisão reúne informações que buscam explicar a insônia, incluindo aquelas que estudam os aspectos psicológicos e os neurobiológicos. A insônia tem sido definida em termos psicológicos (componentes cognitivos, tais como preocupações e ruminação e aspectos comportamentais, tais como o condicionamento clássico) e em termos fisiológicos (taxa metabólica aumentada, com tônus muscular, frequência cardíaca e temperatura aumentados). Do ponto de vista neurobiológico, há duas perspectivas: uma propondo que a insônia ocorre em associação com uma falha na inibição da vigília e outra que considera o hiperalerta como tendo um papel importante na fisiologia do sono. São apresentadas também as estratégias não farmacológicas desenvolvidas para lidar com os diferentes aspectos da insônia.
Subject(s)
Humans , Male , Female , Cognition/physiology , Sleep Initiation and Maintenance Disorders/psychology , Sleep Initiation and Maintenance Disorders/therapy , Sleep/physiology , Cognitive Behavioral Therapy/methods , Risk Factors , Depression/physiopathology , Sleep Initiation and Maintenance Disorders/physiopathologyABSTRACT
Although pharmacological treatment constitutes the main therapeutic approach for depression, non-pharmacological treatments (self-care or psychotherapeutic approach) are usually regarded as more essential therapeutic approaches in clinical practice. However, there have been few clinical practice guidelines concerning self-care or psychotherapy in the management of depression. This study introduces the 'Evidence-Based, Non-Pharmacological Treatment Guideline for Depression in Korea.' For the first time, a guideline was developed for non-pharmacological treatments for Korean adults with mild-to-moderate depression. The guideline development process consisted of establishing several key questions related to non-pharmacologic treatments of depression, searching the literature for studies which answer these questions, assessing the evidence level of each selected study, drawing up draft recommendation, and peer review. The Scottish Intercollegiate Guidelines Network grading system was used to evaluate the quality of evidence. As a result of this process, the guideline recommends exercise therapy, bibliotherapy, cognitive behavior therapy, short-term psychodynamic supportive psychotherapy, and interpersonal psychotherapy as the non-pharmacological treatments for adult patients with mild-to-moderate depression in Korea. Hence, it is necessary to develop specific methodologies for several non-pharmacological treatment for Korean adults with depression.
Subject(s)
Adult , Humans , Bibliotherapy/methods , Clinical Protocols , Cognitive Behavioral Therapy/methods , Combined Modality Therapy/methods , Depression/drug therapy , Exercise Therapy , Placebos/therapeutic use , Surveys and Questionnaires , Republic of KoreaABSTRACT
La hepatopatía grasa no alcohólica es la afección crónica del hígado más frecuente en la mayor parte del mundo. Como en otras enfermedades crónicas no transmisibles, en su tratamiento se han empleado recursos tanto medicamentosos como no farmacológicos. Con el propósito de estimar el uso y el valor respectivo de cada uno en el enfoque terapéutico actual se realiza esta revisión y actualización del tema. Para esto, fueron revisadas las evidencias publicadas, fundamentalmente en artículos de gastroenterología y de otras especialidades que tratan del tema y disponibles en bases de datos electrónicas.
Non alcoholic fatty liver disease is the most frequent chronic liver condition in the world. As in other chronic non-communicable diseases, treatment has used both pharmacological and non-pharmacological resources. In order to estimate the use and value of each current therapeutic approach, a revision for updating on this topic is conducted. Published evidence were reviewed, mainly articles on gastroenterology and other specialties dealing with the topic and which are available in electronic databases.
ABSTRACT
In treatment of depression, non-pharmacological treatment is as important as pharmacological treatment. However, in clinical practice in Korea, non-pharmacological treatment is not provided sufficiently and patients are not satisfied with psychiatric interviews. Accordingly, patients ask for more information from clinicians. Clinicians should be aware of the characteristics of depression in Korean patients, because the manifestations of symptoms are influenced by cultural factors. In particular, depressed patients complain about somatic symptoms more frequently than they complain about depressed mood itself. In order to establish a therapeutic relationship with depressed patients, clinicians should be aware of these characteristics of depressed patients and clinicians should also address the needs of their patients. The author introduces evidence-based self-care methods for Korean patients with depression. St. John's wort, acupuncture, air ionization, light therapy, massage bibliotherapy, exercise, meditation, relaxation, and yoga can be helpful for overcoming depression. Among them, the Clinical Research Center for Depression, an organization supported by the Ministry of Health and Welfare, has recommended several non-pharmacological treatments for depression. First of all, exercise, such as walking more than 30 min. everyday, is strongly recommended. Other recommendations include bibliotherapy, interpersonal psychotherapy, cognitive behavioral therapy, and short-term psychodynamic supportive psychotherapy. For the nationwide management of depression, social bias against the treatment of depression should be reduced and non-pharmacological treatment for depression should be encouraged.