Intervention effect of Tuina pressing and kneading the Huantiao (GB30) acupoint on NF-κB p65 protein at spinal cord dorsal horn in sciatica rats / 中国骨伤

OBJECTIVE@#To observe the analgesic effect of Tuina by pressing and kneading the Huantiao (GB30) acupoint on rats with chronic constriction injury (CCI) and to explore the analgesic mechanism of Tuina on sciatica rats.@*METHODS@#Thirty-two SPF male SD rats weighing 180 to 220 g were randomly divided into fore groups:blank group (without any treatment), sham group (only exposed without sciatic nerve ligating), model group (sciatic nerve ligating) and Tuina group (manual intervention after lsciatic nerve ligating). The CCI model was prepared by ligating the right sciatic nerve of the rats, on the third day of modeling, the rats in the Tuina group were given pressing and kneading the Huantiao (GB30) point for 14 days, and the changes of paw withdrawal threshold(PWT), paw withdrawal latency(PWL) were measured before and on the 1st, 3rd, 7th, 10th, 14th and 17th days after modeling. The changes of sciatic functional index(SFI) were measured before and on the 1st and 17th day after modeling. The morphological changes of the sciatic nerve were observed by hematoxylin-eosin(HE) staining;and the differences in NF-κB protein expression in the right dorsal horn of the spinal cord of rats were detected.@*RESULTS@#Following modeling, there was no significant difference in PWT, PWL and SFI between the blank group and the sham group (P>0.05), but the PWT, PWL and SFI of the model group and the Tuina group decreased significantly (P<0.01). After manual intervention, the pain threshold of rats in Tuina group increased. On the 8th day of manual intervention (the 10th day after modeling), PWT in Tuina group increased significantly compared with that in model group (P<0.01). On the 5th day of manual intervention (the 7th day after modeling), the PWL of the massage group was significantly higher than that of the model group (P<0.01). The pain threshold of rats in Tuina group continued to rise with the continuous manipulation intervention. After 14 days of manipulative intervention, the sciatic nerve function index of rats in the Tuina group increased significantly(P<0.01). Compared with the blank group and sham group, the myelinated nerve fibers of sciatic nerve in the model group were disordered and the density of axons and myelin sheath was uneven. Compared with the model group, the nerve fibers of rats in the Tuina group were gradually continuous and the axons and myelin sheath were more uniform than those in the model group. Compared with the blank group and sham group, the expression of NF-κB protein in the right spinal dorsal horn of the model group was significantly increased(P<0.01). Compared with the model group, the expression of NF-κB protein in the right spinal dorsal horn of rats in Tuina group decreased significantly(P<0.01).@*CONCLUSION@#Pressing and kneading the Huantiao (GB30) point restores nerve fiber alignment;and improves the PWT、PWL and SFI in the CCI model by decreasing NF-κB p65 protein expression in the spinal dorsal horn. There fore, Tuina demmstrates an analgesic effect and improves the gait of rats with sciatica.

Therapeutic effect of Fanzhen Jieci needling on discogenic sciatica: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the therapeutic effect between Fanzhen Jieci (warming acupuncture plus fast needling) combined with conventional acupuncture and simple conventional acupuncture on discogenic sciatica.@*METHODS@#A total of 76 patients with discogenic sciatica were randomized into a Fanzhen Jieci group and a conventional acupuncture group, 38 cases in each one. Conventional acupuncture was applied at Shenshu (BL 23), Dachangshu (BL 25), L1-L5 Jiaji (EX-B 2) and Huantiao (GB 30) on the affected side, etc. in the conventional acupuncture group. On the basis of the treatment in the conventional acupuncture group, Fanzhen Jieci was applied at L1-L5 Jiaji (EX-B 2) and Huantiao (GB 30) on the affected side in the Fanzhen Jieci group, i.e. warming acupuncture was applied at L1-L5 Jiaji (EX-B 2), and fast needling was applied at Huantiao (GB 30) on the affected side for a depth of 40-60 mm, so as to introduce a sensation of electric shock transmitting to lower limb, and then the needle was immediately withdrawn. The treatment was given once every other day, 3 times a week for 3 weeks in both groups. The visual analogue scale (VAS) score of leg and low back pain, the Oswestry disability index (ODI) score and the 36-item short form health survey (SF-36) score before and after treatment were compared between the two groups.@*RESULTS@#Compared before treatment, the VAS scores of leg and low back pain and the ODI scores after treatment were decreased in both groups (P<0.001), the changes of the VAS scores of leg and low back pain in the Fanzhen Jieci group were larger than those in the conventional acupuncture group (P<0.05). After treatment, except for the role emotional and health transition scores, the various scores of SF-36 were increased compared before treatment in the Fanzhen Jieci group (P<0.01); except for the role physical, role emotional and health transition scores, the various scores of SF-36 were increased compared before treatment in the conventional acupuncture group (P<0.01). After treatment, the physical functioning, role physical, bodily pain, mental health and general health scores of SF-36 in the Fanzhen Jieci group were higher than those in the conventional acupuncture group (P<0.05).@*CONCLUSION@#Fanzhen Jieci combined with conventional acupuncture can effectively relieve the pain and improve the mental state in patients with discogenic sciatica, its therapeutic effect is superior to simple conventional acupuncture.

Effect of moxibustion on expression of GAP-43 in sciatic nerve trunk and ventral horn of spinal cord of rats with primary sciatica and its nerve repair function / 中国针灸

OBJECTIVE@#To observe the effect of moxibustion at "Huantiao" (GB 30) on the expression of growth-associated protein-43 (GAP-43) in the sciatic nerve trunk and ventral horn of spinal cord (L@*METHODS@#A total of 48 healthy male SD rats were randomly divided into a normal group, a sham operation group, a model group and a moxibustion group, 12 rats in each group. The rat model of primary sciatic pain was established by chronic constriction injury (CCI) of the sciatic nerve in the model group and the moxibustion group. On the 8th day of the experiment, moxibustion was adopted at "Huantiao" (GB 30) in the moxibustion group for 5-10 min, once a day for 14 consecutive days. Sciatic nerve function index (SFI) was measured and compared in each group at day 1, 7, 14 and 21. On the 21st day of the experiment, HE staining was used to observe the morphology of ventral horn of rat spinal cord and sciatic nerve trunk. Immunohistochemical method and real-time PCR were used to detect mRNA and protein expressions of GAP-43 in the spinal cord and sciatic nerve trunk of rats.@*RESULTS@#On day 7, 14 and 21, there was no statistical difference in SFI between the sham operation group and the normal group (@*CONCLUSION@#Moxibustion at "Huantiao" (GB 30) could improve the sciatic nerve function in rats with primary sciatica and its mechanism may be related to improving the expression of GAP-43 and enhancing the self-repair ability of the sciatic nerve after injury.

Variante de colgajo de rotación tipo Hamstring para reconstrucción de úlcera isquiática / Hamstring rotation fl ap variant for ischial ulcer reconstruction

Antecedentes. El colgajo Hamstring es una opción válida para la reconstrucción de úlceras isquiáticas. Las úlceras por presión representan un verdadero desafío para el cirujano plástico. Requieren un tratamiento especializado y multidisciplinario por su alta probabilidad de recidiva y las complicaciones en su manejo. Por lo general, ocurren por presión sostenida sobre la tuberosidad isquiática. Caso clínico. Se presenta el caso de un paciente parapléjico desde el nacimiento secundario a mielomeningocele con diagnóstico actual de úlcera isquiática. Se le realizaron durante 3 años múltiples intentos de cierre quirúrgico alternando medidas conservadoras, sin éxito. A la exploración física presenta una úlcera isquiática izquierda de 6x6 cm a la que se le realizó aseo y desbridación quirúrgica más cierre por medio de un colgajo Hamstring modificado. A los 7 días presentó dehiscencia de herida la cual se manejó de manera conservadora y cierre primario diferido a las 4 semanas. A 8 meses de posoperatorio el paciente se encuentra con buena evolución y con resultado estético y funcional aceptable, por otra parte, se encuentra sin recidiva, lo que ha permitido su reinserción laboral y un buen equilibrio físico-psico-emocional. Conclusión. El objetivo de este colgajo es brindar cobertura al área isquiática sin afectar estructuras adyacentes, lo cual requiere de un amplio conocimiento de la anatomía de la región femoral, así como de los colgados tanto locales como regionales que podemos utilizar para la reconstrucción. Actualmente este colgajo es una opción terapéutica efectiva para el tratamiento de úlceras isquiáticas refractarias en centros que cuentan con cirujanos plásticos no especializados en microcirugía.

Background. The Hamstring fl ap is an adequate option for ischial ulcers reconstruction. Pressure ulcers represent a real challenge for the plastic surgeon. They require specialized and multidisciplinary treatment due to their high recurrence probability and complications in their management. Regularly, pressure ulcers occur when sustained pressure is applied on the ischial tuberosity. Case report. We report a case of a 23-year-old paraplegic male with myelomeningocele complaining for an ischial ulcer. Multiple attempts to surgical closure were made during three years along with conservative management, without success. Physical examination revealed a 6x6 cm left ischial ulcer, which was managed with surgical debridement and closure with a modifi ed Hamstring fl ap. After 7 days, the patient presented wound dehiscence, which was managed conservatively and primary delayed closure after 4 weeks. 8 months postoperatively the patient has a good evolution and an acceptable functional and aesthetic result, without recurrence, which has allowed his reintegration into work and a good physical-psycho-emotional balance. Conclusion. The objective of this fl ap is to provide coverage to the ischial area without aff ecting adjacent structures, which requires a broad knowledge of the anatomy of the femoral region, as well as the local and regional fl aps that can be used for reconstruction. Nowadays this fl ap is an eff ective therapeutic option for the treatment of refractary ischial ulcers in plastis suergery centers without microsurgery.

Uso de pregabalina en el tratamiento de la lumbociatalgia / Pregabalin for treatment of low back pain

La lumbociatalgia es un problema clínico común, que en la mayoría de los casos se autolimita y se puede tratar en forma conservadora, usando medidas no farmacológicas y analgésicos como paracetamol o los antiinflamatorios no esteroi-deos. Otro medicamento muy utilizado en nuestro medio es la pregabalina, a pesar de que no se encuentra aprobada para dicha indicación. En este trabajo, el autor se pregunta acerca de la utilidad clínica de la pregabalina y luego de hacer una búsqueda bibliográfica sobre la evidencia más actualizada y de mejor calidad acerca del tema, concluye que no es efectiva para lumbociatalgia y que se acompaña de efectos adversos significativos. Esto coincide con las recomenda-ciones de las guías internacionales, que en su mayoría desaconsejan el uso de anticonvulsivantes para la lumbalgia. (AU)

Sciatica is a common clinical situation, in most cases self-limited and which can be managed conservatively with nonpharmaco-logic treatment and analgesics, such as paracetamol or nonsteroidal anti-inflammatory drugs. Pregabalin is also commonly used, despite not being approved for this indication. In this article, the author queries about the clinical usefulness of pregabalin, and after carrying out a bibliographic search of the most recent and best-quality evidence, concludes that it is not effective in sciatica while it causes significant adverse effects. This is in line with the recommendations of most international guidelines,that do not recommend the use of anticonvulsivants drugs for the treatment of lumbalgia. (AU)

Tratamento cirúrgico de úlcera por pressão na unidade de Pediatria de hospital de reabilitação / Pressure ulcer treatment in the Pediatric Unit of a Rehabilitation Hospital

Introdução: A úlcera por pressão (UPP) é uma das complicações mais comuns em portadores de lesão medular, dos mais graves e frequentes problemas destes pacientes. A incidência e evolução depende dos grupos estudados, tendo as crianças e adolescentes características específicas durante o crescimento. A maior parte das descrições na literatura referem-se a adultos que desenvolveram UPP durante internação. O objetivo é descrever os resultados de pacientes operados para fechamento de úlcera por pressão na unidade de Pediatria do Hospital Sarah Brasília. Métodos: Estudo descritivo, retrospectivo de pacientes operados de 2005 a 2010 devido à lesão por pressão e análise estatística. Resultados: 116 pacientes foram admitidos para tratamento cirúrgico de UPP no Hospital Sarah, sendo 20 (17,2%) internados na Pediatria; 15 (75%) homens e 5 (25%) mulheres, todos provenientes de ambiente comunitário; 60% localizadas na região isquiática; com seguimento de 15 anos; 70% eram portadores de malformação do tubo neural. Os procedimentos cirúrgicos foram indicados para úlcera por pressão grau III e IV. Utilizou-se retalho do músculo glúteo (3), em ilha (8) ou península (3), fechamento primário e coccigectomia; retalho do músculo tensor da fáscia lata. Três casos apresentaram complicações, 65% evoluíram com recidiva e 15% com surgimento de novas lesões na região pélvica. Conclusão: A principal causa de lesão por pressão em Pediatria foi devido à malformação do tubo neural (70%), adquiridas na comunidade, localizadas na região isquiática. Embora estivessem em atendimento no programa de reabilitação, ainda foi observado alto índice de recidivas (65%).

Introduction: Pressure ulcers (PUs), or pressure sores, are among the most common serious complications in patients with spinal cord injury. The incidence and evolution in children and adolescents have specific characteristics. Most prior reports evaluated adults who developed PUs in the hospital. The objective is to describe the outcomes of surgical PU closure in children and adolescents in the Hospital Sarah Brasília pediatric unit. Methods: This was a retrospective statistical analysis of patients who underwent surgery for PUs. Statistical analysis of the incidence of PUs was performed using Epi Info version 3.2.2. Results: Of 116 patients who underwent surgery for PUs at the Hospital Sarah between 2005 and 2010, 20 (17.2%) were admitted to the Pediatric Unit. All 15 (75%) male and 5 (25%) female patients were admitted from a community setting. PUs were located in the ischial region in 60% of patients. The followup period was 15 years. Neural tube malformations were present in 70% of patients. We performed surgery for grade III and IV PUs, using gluteal flaps, primary closure and coccygectomy, and tensor fascia lata flaps. Three cases had complications, 65% developed recurrences, and 15% developed new ulcers in the pelvic region. Conclusion: The main cause of PUs in pediatric cases admitted to the rehabilitation hospital was a neural tube malformation (70%) in the ischial region. Despite admission to the rehabilitation program, a high recurrence rate (65%) was observed.

Uso da corrente catódica de alta voltagem sobre a dor em compressão nervosa experimental / Use of high-voltage cathodic current for pain in experimental nerve compression

OBJETIVO: Avaliar o efeito da corrente catódica de alta voltagem sobre a dor em um modelo experimental de ciatalgia. MÉTODOS: Foram utilizados 16 ratos Wistar, machos, submetidos a um modelo de ciatalgia experimental no membro pélvico direito. Os sujeitos foram divididos em grupo simulacro (GS) e grupo tratado com corrente catódica (GP-) por 20 min diários durante 10 dias. O modelo de compressão foi realizado com amarria por fio catgut 4.0 cromado, em quatro pontos ao longo do nervo isquiático. A avaliação da nocicepção foi realizada, de forma funcional, com o tempo de elevação da pata (TEP), e à pressão, pelo limiar de retirada, via analgesímetro eletrônico. Os dados foram coletados antes do modelo de ciatalgia (AV1), três dias depois da compressão (antes, AV2, e após o tratamento, AV3), após o quinto dia de tratamento (AV4) e em seguida ao décimo dia de tratamento (AV5). RESULTADOS: Pela avaliação funcional, em ambos os grupos houve aumento da nocicepção, sem redução da mesma em qualquer momento da avaliação. À pressão, no entanto, o GS mostrou redução do limiar de retirada em todos os momentos, enquanto o GP- apresentou redução do limiar apenas inicialmente - em AV5 o limiar foi restaurado. CONCLUSÃO: Não houve alteração na nocicepção pela avaliação funcional; porém, à pressão, o tratamento com corrente catódica mostrou efeito com a somatória de terapias.

OBJECTIVE: To assess the effect of high-voltage cathodic current on pain from a sciatica experimental model. METHODS: A total of 16 male Wistar rats were submitted to the sciatica experimental model in the right hind paw. They were divided into sham group (GS) and group treated with cathodic current (GP-) for 20 min/daily, for 10 days). The model of sciatic compression was performed with a 4.0-chromic catgut thread tie in four points of the sciatic nerve. Assessment of nociception was performed by measuring the time during which the animal held its hind paw in a guarded position (THHP) and the pressure withdrawal threshold, by use of a digital electronic analgesymeter. Data collection was carried out before the sciatica experimental model (AS1), three days after compression (before, AS2, and after treatment, AS3), and five and 10 days after treatment (AS4 and AS5, respectively). RESULTS: According to the functional disability test, both groups showed an increase in nociception, with no reduction at any assessment time. Submitted to pressure, however, GS showed a reduction in the hind paw withdrawal threshold at all assessment times, while GP- showed a reduction in the hind paw withdrawal threshold only initially - at AS5, the threshold was restored. CONCLUSION: No change in nociception was observed on functional assessment; however, on pressure hind paw withdrawal assessment, the treatment with cathodic current showed to be effective with the summation of therapies.

Hérnia discal lombar / Lumbar disc herniation

A hérnia discal lombar é o diagnóstico mais comum dentre as alterações degenerativas da coluna lombar (acomete 2 a 3 por cento da população) e a principal causa de cirurgia de coluna na população adulta. O quadro clínico típico inclui lombalgia inicial, seguida de lombociatalgia e, finalmente, de dor ciática pura. A história natural da hérnia de disco é de resolução rápida dos sintomas (quatro a seis semanas). O tratamento inicial deve ser conservador, com manejo medicamentoso e fisioterápico, podendo ser acompanhado ou não por bloqueios percutâneos radiculares. O tratamento cirúrgico está indicado na falha do controle da dor, déficit motor maior que grau 3, dor radicular associada à estenose óssea foraminal ou síndrome de cauda equina, sendo esta última uma emergência médica. Uma técnica cirúrgica refinada, com remoção do fragmento extruso, e preservação do ligamento amarelo, resolve a sintomatologia da ciática e reduz a possibilidade de recidiva em longo prazo.

Lumbar disc herniation is the most common diagnosis amongst the degenerative conditions of the lumbar spine (affecting around 2 to 3 percent of the population), and is the principal cause of spine surgery in the adult population. The typical clinical picture includes initial lumbalgia, followed by progressive sciatica. The natural history of disc herniation is one of rapid resolution of the symptoms (from 4-6 weeks). Early treatment should be conservative, with pain management and physiotherapy, sometimes associated with selective nerve root block. Surgery should be considered if pain management is unsuccessful, if there is a motor deficit (strength grade 3 or less), where there is radicular pain associated with foraminal stenosis, or in the presence of cauda equina syndrome, the latter representing a medical emergency. A refined surgical technique, with removal of the extruded fragment and preservation of the ligamentum flavum, resolves the sciatic symptoms and reduces the risk of recurrence in the long term.

Efeitos do ultrassom terapêutico em modelo experimental de ciatalgia / Therapeutic ultrasound effects in a sciatica experimental model

A ciática possui grande prevalência geral e seu tratamento tende a resolver as causas de compressão nervosa. A fisioterapia objetiva reduzir os sintomas causados pela compressão. O presente estudo teve como objetivo avaliar a eficácia do ultrassom terapêutico sobre a dor, em animais submetidos a modelo experimental de ciatalgia. Foram usados 18 ratos neste estudo, divididos em três grupos: GS (n = 4), submetido a modelo de ciatalgia e tratados com ultrassom desligado; GUP (n = 7), submetido à ciatalgia e tratados com ultrassom pulsado 2W/cm² (SATP; 0,4 - SATA); e grupo GUC (n = 7), submetido à ciática e ultrassom contínuo (0,4W/cm²). O nervo ciático do membro posterior direito foi exposto à compressão com fio categute em quatro pontos. No 3º dia pós-operatório (PO), iniciou-se tratamento indireto por quatro dias. No 9º dia PO, o tratamento direto começou sobre a área do procedimento cirúrgico, por cinco dias consecutivos. O tempo de elevação da pata, durante a marcha, foi avaliado antes e após a ciatalgia, no 3º, 6º, 9º e 13º PO. Os resultados demonstraram que a aplicação do ultrassom reduziu a dor com ambos os tratamentos efetivos e tendeu a ser mais eficaz na forma pulsada.

The sciatica possesses great general population prevalence, and its treatment tends to solve the nervous compression causes. Physiotherapy aims to reduce the symptoms caused by compression. This study aimed to evaluate the effectiveness of therapeutic ultrasound on pain in animals subjected to sciatica experimental model. Eighteen rats were used and they were divided in 3 groups: group SG (n=4) submitted to the sciatica and treated with the ultrasound off, group PUG (n=7) submitted to the sciatica and treated with pulsed ultrasound 2 W/cm² (SATP; 0,4 - SATA) and group CUG (n=7) submitted to the sciatica and treated with continuous ultrasound (0,4 W/cm²). The sciatic nerve of the posterior right limb was exposed to the compression with Catgut wire in 4 points. In the 3rd postoperative day, the indirect treatment was started (right inferior limb) for four days. In the 9th postoperative day, the direct treatment begins on the surgical procedure area for 5 serial days. The paw elevation time, during the march, of the animal was verified before and after the sciatica, at the 3rd, 6th, 9th and 13th postoperative day. The results demonstrated that the application of the therapeutic ultrasound reduced the pain with both treatments in PUG and CUG, and it has tended larger effectiveness in the pulsed form.

uncommon cause of sciatica

A 67-year-old male patient underwent a left nephrectomy for a renal cell carcinoma. Thirty-eight months later, he presented with right sided lower backache, radiating to the posterior aspect of his thigh, calf and foot, paraesthesiae and numbness in the distribution of the right S1 and S2 dermatomes. The presumptive diagnosis was of nerve root entrapment secondary to a disc prolapse. MRI scan of the lumbosacral spine revealed an enlarged S1 root canal containing a solid solitary lesion suggestive of a neurofibroma of the S1 nerve root. Because of persistent pain, he underwent a right L5/S1 hemilaminectomy. A lesion originating from the right S2 nerve root was found and excised. The patient made an uneventful postoperative recovery with complete resolution of his right leg pain. The histopathological examination revealed a portion of the nerve root and dorsal root ganglion infiltrated by metastatic renal cell carcinoma. Although uncommon, nerve root infiltration by a metastasis should be included in the differential diagnosis of back pain and sciatica, especially if there is a previous history of malignant disease

Síndrome lumbociático / Lumbosciatic syndrome

En el presente trabajo se analiza la evolución histórica del concepto de lumbociática y se hace énfasis en las distintas causas que lo producen, así como también en las regiones donde se puede producir la compresión radicular, plexo lumbosacro o la compresión troncular y los atrapamientos neurales que pueden simular un síndrome lumbociático. También se destaca que el tratamiento es distinto, dependiendo de la etiología y el lugar o sitio anatómico donde se produce la compresión de los elementos nerviosos. Así mismo, se realiza un análisis de las diferentes regiones donde se puede producir la compresión de las raíces lumbares, del plexo lumbosacro o del tronco ciático en su emergencia por la pelvis (síndrome piriforme), por lo anterior el tratamiento se orienta en base a la etiología del síndrome y a la región donde se produce la compresión, lo que permite sistematizar el estudio y el diagnóstico del síndrome lumbociático.

Treatment of sciatica at high altitude

Sciatic nerve block is one of the various diagnostic and therapeutic modalities for acute or chronic pain in the leg and foot. A randomized, retrospective, clinical study of 103 patients with symptoms of sciatic nerve root pain, was carried out at a remote place in the Northern areas at altitudes ranging from 9500-12000 feet. The inclusion criteria were; compromised morbidity, pain not responding to NSAIDs and a history of over one year. Age groups were 40-60 years and male to female ratio was 12:1. Ninety patients were given 0.125% bupivacain and 13 were given 0.5% lignocaine with 1:800,000 adrenaline. Patients were put on aspirin 300 and ibuprofen 200 mg thrice a day for three days. A follow up of 4-6 months revealed a complete relief in 80% of the cases. Of the rest 20% most were those treated with lignocaine. An unexpected finding was that 80% of patients in bupivacain group had motor blockade and 20% had dense sensory block even at this lower concentration. In lignocaine group 100% of the patients had dense sensory blockade. We conclude that both lignocaine and bupivacain are effective in treating sciatica by sciatic nerve block at high altitude, bupivacain being a better choice; the population at this altitude is hyperreactive to both the drugs

Analgesia acupuntural y bloqueos terapéuticos en pacientes con lumbociatalgia: labor de enfermería / Acupuncture analgesia and therapeutic blocks in patients With lumbosciatica. Nursing work

Se realizó un estudio analítico, longitudinal y prospectivo acerca de la analgesia acupuntural y los bloqueos terapéuticos empleados como procedimiento en 200 pacientes con lumbociatalgia, atendidos en la clínica para el tratamiento del dolor del Hospital General Docente "Alberto Fernández Montes de Oca" de San Luis, provincia de Santiago de Cuba, durante el período comprendido desde julio de 1996 hasta marzo de 1997, con el objetivo de precisar la respuesta al tratamiento, comparar su efectividad y mostrar la labor de Enfermería en la aplicación de ambas técnicas. Se encontró que el tratamiento acupuntural del dolor lumbociático produjo analgesia en todos los pacientes tratados con este método, que además de ser inocuo, resultó de muy bajo costo y arrojó una diferencia de $ 8 513 en comparación con la técnica tradicional(AU)

An analytical, longitudinal and prospective study about acupuncture analgesia and therapeutic blocks used a procedure in 200 patients with lumbosciatica attended at the clinic for the treatment of pain of the "Alberto Fernández Montes de Oca" General Teaching Hospital, in San Luis, province of Santiago de Cuba, from July, l996, to March, l997, was conducted aimed at determining the response to treatment, comparing its effectiveness and showing the work carried out by the nurses in the application of both techniques. It was found that the acupuncture treatment of lumbosciatica produced release in all the patients treated by this method, that besides being innocuos was very cheap. There was a difference of $8 513 compared with the traditional technique(AU)

Effect of hyperbaric oxygen on the regeneration of experimental crush injuries of nerves

O oxigenio hiperbarico exerce efeitos comprovadamente beneficos no tratamento de lesoes isquemicas agudas de partes moles e em feridas de dificil cicatrizacao. Nas lesoes neurais por esmagamento, os mecanismos fisiopatologicos assemelham-se aos efeitos dependentes da isquemia tissular. Portanto, a terapia com oxigenio hiperbarico teria participacao nos processos de reparacao neural, que constitui um dos pontos criticos para a recuperacao funcional apos as lesoes por esmagamento de nervos perifericos...

Manuseio da dor radicular da hérnia discal lombar com o uso de betametasona por via epidural / Management of radicular pain from lumbar herniated disk using betamethasone epidural injection

Os autores analisam o resultado do tratamento de 45 casos de dor radicular na hérnia discal lombar, com o uso de betametasona por via peridural, tendo como base para isso um provável importante papel do processo inflamat¢rio na ciatalgia da hérnia discal. O critério para admissão ao estudo foi a existência de dor com caracter¡stica radicular, sinais cl¡nicos de tensão da raiz e confirmação através de CT ou ressonância, da imagem de hérnia discal. Os resultados foram classificados em excelentes (31,1 por cento), bons (62,2 por cento) e ruins (6,7 por cento). A via utilizada foi a interlaminar lombar. Concluem ser o bloqueio peridural com betametasona um bom método de tratamento da dor radicular lombar.

Acupuntura en algunos cuadros reumatológicos corriente / Acupuncture in some usual rheumatologic conditions

Se presentan en forma preliminar, los resultados obtenidos con acupuntura en un grupo de 52 pacientes portadores de hombros dolorosos (29 casos) y de ciáticas, lumbagos y cruralgias (23 casos). Estos enfermos fueron referidos al Consultorio de Medicina del Hospital desde la Atención primaria por su cronicidad y refrctariedad a los tratamientos habituales. En esta casuística, el seguimiento hasta los 4 meses demostró desaparición del dolor en el 65 porciento de los casos de ciática y lumbago y en el 60 porciento de los hombros dolorosos; su disminución en el 20 y 24 porciento respectivamente y la consiguiente mejoría funcional. Estos resultados deberán ser debidamente confirmados a través del estudio y seguimiento de casuísticas más numerosas y con una metódica más exigente de evaluación de resultados