ABSTRACT
INTRODUCTION: Treatment of functional disorders of the anorectal unit should focus on the underlying cause. Biofeedback therapy is a functional retraining of the pelvic floor that has proven useful in the treatment of constipation associated with dyssynergia and in the management of fecal incontinence. This study describes the first experiences with this form of biofeedback therapy in Colombia. OBJECTIVE: Describe our experience with biofeedback therapy in the gastrointestinal neurophysiology unit. MATERIALS AND METHODS: This historical cohort included patients with an indication for biofeedback therapy for constipation or fecal incontinence in the gastrointestinal neurophysiology unit during the data collection period. The response to therapy is described by comparing manometricfindings before and after 10 biofeedback sessions. RESULTS: 21 patients were included(71.4% women, the average age was 68, 9 with constipation and 12 with fecal incontinence.Among the patients with constipation there was a significant improvement in 71.4% of those who had rectal hyposensitivity and in 57.1% of those with dyssynergia. Biofeedback therapysignificantly increased the balloon expulsion rate (11.1 vs. 66.7%, p=0.02). In patients with fecal incontinence, there was improvement in 50% of those who had anal hypotonia and in 80% of those who had anal hyposensitivity. CONCLUSIONS: This study demonstrates that biofeedback therapy has a favorable impact on a high number of patients with constipationand fecal incontinence; in our center, the response is similar to that of the world literature.
Subject(s)
Biofeedback, Psychology , Constipation , Fecal Incontinence , Humans , Fecal Incontinence/therapy , Constipation/therapy , Constipation/physiopathology , Biofeedback, Psychology/methods , Female , Colombia , Male , Aged , Middle Aged , Treatment Outcome , Aged, 80 and over , Adult , ManometryABSTRACT
We report the case of a 71-year-old woman with multiple comorbidities who was admitted to the hospital due to hematochezia, without hemodynamic instability. Initial investigations, including colonoscopy and upper endoscopy, did not reveal the cause of bleeding. However, the patient experienced increased bleeding, anemia, and hemodynamic instability during her hospital stay. Subsequent selective angiography did not show any signs of active bleeding. In light of the persistent shock, surgical intervention was performed, which revealed blood originating from multiple diverticula in the jejunum.
Se presenta el caso de una mujer de 71 años con múltiples comorbilidades que ingresó por hematoquecia sin inestabilidad hemodinámica. Se inició el estudio con una colonoscopia sin evidenciar la causa; durante la estancia hospitalaria presentó un aumento del sangrado, anemización e inestabilidad hemodinámica, por lo que se realizó una endoscopia digestiva alta sin hallazgos; posteriormente, se realizó una angiografía selectiva sin evidencia de sangrado activo. Ante el choque persistente se llevó a cirugía en la que se evidenció sangre proveniente del intestino delgado secundaria a la presencia de divertículos múltiples en el yeyuno.
ABSTRACT
Introducción: En la actualidad, presentar síntomas de ansiedad y depresión parece ser el común denominador entre la población que padece algún tipo de dolor crónico. Son muchas las estrategias que desde la fisioterapia se han venido implementando en el tratamiento sobre el mismo; actualmente existe un creciente interés por conocer la eficacia de estas intervenciones disciplinares, las cuales respondan a las múltiples necesidades del paciente con dolor crónico. El propósito de este estudio es conocer y describir cuál es la eficacia de la fisioterapia sobre la ansiedad y la depresión en pacientes con dolor crónico. Metodología: Se realizó una búsqueda en las bases de datos PubMed, Scopus, Clinicalkey y ScienceDirect para ensayos clínicos controlados aleatorios publicados entre 2015-2021. Los estudios se filtraron por lectura de título y abstract, arbitraje por pares a través del software Ryan, lectura del artículo en texto completo y selección de artículos según criterios CONSORT. El riesgo de sesgo y la calidad metodológica de los ensayos incluidos fueron evaluados de manera independiente utilizando la herramienta de evaluación del riesgo de sesgo de Cochrane (RoB) y la escala PEDro. Resultados: En total se incluyeron 20 ensayos clínicos. La revisión sistemática encontró efectos clínicamente significativos en las múltiples estrategias de intervenciones que desde la fisioterapia se emplean para el manejo de ansiedad y depresión en pacientes con dolor crónico. Conclusiones: Según lo hallado en esta revisión sistemática se puede demostrar la eficacia de la fisioterapia entre las variables de ansiedad y depresión entre pacientes con dolor crónico.(AU)
Introduction: Nowadays, presenting symptoms of anxiety and depression seems to be the common denominator among the population suffering from some type of chronic pain. There are many strategies that have been implemented in the treatment of physical therapy; Currently, there is a growing interest in knowing the effectiveness of these disciplinary interventions which respond to the multiple needs of the patient with chronic pain. The purpose of this study is to know and describe the effectiveness of physical therapy on anxiety and depression in patients with chronic pain. Methodology: A search was performed in PubMed, Scopus, Clinicalkey and ScienceDirect databases for randomized controlled clinical trials published between 2015 - 2021. The studies were filtered by title and abstract reading, peer review through the Ryan software, reading the article in full text and selection of articles according to CONSORT criteria. The risk of bias and the methodological quality of the included trials were independently evaluated using the Cochrane Bias Risk Assessment Tool (RoB) and the PEDro scale. Results: A total of 20 clinical trials were included. The systematic review found clinically significant effects in the multiple intervention strategies employed since physiotherapy for the management of anxiety and depression in patients with chronic pain. Conclusions: As found in this systematic review, the efficacy of physiotherapy among anxiety and depression variables among patients with chronic pain can be demonstrated.(AU)
Subject(s)
Humans , Female , Physical Therapy Specialty , Anxiety , Chronic Pain , Depression , Pain , Pain ManagementABSTRACT
El artículo describe el caso de un paciente de 28 años de edad con antecedente de VIH, quien presentaba múltiples lesiones en la piel y las mucosas, producto de sífilis secundaria, y quien mostraba un amplio espectro de manifestaciones cutáneas características de esta enfermedad.
We describe the case of a 28-year-old patient with HIV history who has multiple skin and mucous lesions that showing a broad spectrum of cutaneous manifestations of secondary syphilis.
