ABSTRACT
Introducción. El dolor crónico supone un importante obstáculo para mantener la funcionalidad y la independencia. Estudios previos han demostrado que la música puede mejorar la motivación y los sentimientos positivos de autocontrol frente al dolor. Objetivos. Descubrir qué estrategias de afrontamiento frente al dolor crónico son las más utilizadas por los pacientes y cómo se modifican al aplicar un programa de musicoterapia, en una muestra de pacientes con dolor lumbar crónico Material y métodos. 14 pacientes de la Unidad de Dolor del Hospital San Pedro de Logroño con dolor lumbar crónico fueron admitidos a un programa de musicoterapia durante seis semanas. Las sesiones fueron semanales, de una hora de duración, dirigidas por un musicoterapeuta que aplicó diferentes protocolos. El Cuestionario de Afrontamiento al Dolor CAD fue autoadministrado a los pacientes al inicio y al término del programa de musicoterapia. La intensidad del dolor se midió al principio y al final de cada sesión mediante la escala EVA. Resultados. La estrategia más utilizada frente al dolor fue la búsqueda de información. Todas las estrategias fueron más utilizadas al finalizar el programa de musicoterapia, aunque las diferencias fueron significativas sólo en tres de ellas: Búsqueda de información, Catarsis y Distracción. Conclusiones. Nuestro programa de musicoterapia resultó una herramienta efectiva para disminuir el dolor lumbar crónico al ser capaz de afectar a la percepción del dolor en su componente cognitivo, permitiendo a los pacientes desviar el foco del dolor del estimulo aversivo y mostrando una mayor destreza en el uso de estrategias de afrontamiento que permiten una adaptación positiva al dolor crónico (AU)
Background. Chronic pain represents a significant obstacle in maintaining function and independence. Previous studies have shown that music can improve motivation and increase feelings of control in patients with chronic pain. Objective. To examine the influence of a musictherapy program on chronic low back pain patients related to coping strategies. Material an method. 14 patients from the Pain Unit in the San Pedro Hospital of Logroño were included in a music-therapy program during six weeks with a dignosis of chronic low back pain. Subjects were weekly visited by a music therapist, 60 min per sesión. All the patients answered a questionnarie to evalúate the used coping strategies to pain (CAD), in the first and the end visits. In adittion, a severity pain scale (VAS) was answered twice in each interventional session. Results. The pain coping strategy more frecuently used was information seeking. All strategies shown better results at the end of the program, but only two of them had significant results: information seeking, catarsis, and distraction. Conclusión. The music-therapy program increased the more active pain coping estrategies that are possitively associated to a better degree of adjustment of the patient with chronic low back pain (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Low Back Pain/diagnosis , Low Back Pain/therapy , Music Therapy/methods , Music Therapy/trends , /instrumentation , /methods , Surveys and Questionnaires , Music Therapy/instrumentation , Music Therapy/statistics & numerical data , Motivation , Catharsis , Data Collection/methods , Data Collection/statistics & numerical dataSubject(s)
Amides/administration & dosage , Analgesia, Epidural , Analgesia, Obstetrical , Anesthetics, Local/administration & dosage , Hemodynamics/drug effects , Pregnancy Complications , Transposition of Great Vessels/complications , Wolff-Parkinson-White Syndrome/complications , Adult , Amides/pharmacology , Anesthetics, Local/pharmacology , Calcium Channels/drug effects , Female , Humans , Pregnancy , Pregnancy Complications/physiopathology , Ropivacaine , Sodium Channels/drug effects , Transposition of Great Vessels/physiopathology , Transposition of Great Vessels/surgery , Wolff-Parkinson-White Syndrome/physiopathologyABSTRACT
No disponible
Subject(s)
Pregnancy , Adult , Female , Humans , Analgesia, Epidural , Analgesia, Obstetrical , Pregnancy Complications , Transposition of Great Vessels , Calcium Channels , Sodium Channels , Wolff-Parkinson-White Syndrome , Amides , Anesthetics, Local , HemodynamicsABSTRACT
No disponible
Subject(s)
Pregnancy , Female , Humans , Anesthesia, Obstetrical , Anesthesia, Conduction , Safety , Time Factors , Elective Surgical Procedures , Preanesthetic Medication , Pregnancy Complications, Hematologic , Pulmonary Embolism , Thrombophilia , Antithrombin III Deficiency , Antithrombin III , Anticoagulants , Cesarean Section , Drug Administration Schedule , Anesthesia, General , Heparin, Low-Molecular-WeightABSTRACT
A 34-year-old woman 22 weeks pregnant suffered cerebral hemorrhage, requiring admission to the intensive care unit and mechanical ventilation. She recovered without sequelae. The diagnosis was moyamoya disease and she was scheduled for elective cesarean delivery at 38 weeks of gestation. After appropriate preoperative study and complementary testing (echocardiogram, computerized axial tomography of the brain and determination of anti-cardiolipin and other antibodies, which were normal) the patient was given intradural anesthesia with 15 mg of 0.5% bupivacaine and 24 micrograms of fentanyl, with continuous monitoring of blood pressure, tympanic temperature and neurological variables. Warm intravenous fluids and ephedrine (100 to 250 micrograms/min) were perfused. No noteworthy neurological events or hemodynamic changes occurred during or after surgery. Postoperative analgesia was provided with 2 mg/12 h of morphine through an epidural catheter.
Subject(s)
Anesthesia, Obstetrical , Moyamoya Disease/complications , Adult , Analgesia, Epidural , Female , Humans , Morphine/therapeutic use , Moyamoya Disease/physiopathology , Narcotics/therapeutic use , Pain, Postoperative/drug therapy , PregnancySubject(s)
Goiter/surgery , Laryngeal Masks , Aged , Aged, 80 and over , Female , Humans , Intubation, IntratrachealABSTRACT
The capacity for greater fat absorption relative to carbohydrate absorption in protracted diarrhea of infancy was studied in a developed and a developing country (Buffalo, NY, and Bangkok, Thailand). Fifty patients with protracted diarrhea in the first year of life (defined as liquid stools of more than 20 mL/kg per day with more than a 14-day duration) were randomly assigned to receive either a standard semielemental diet (Pregestimil) or a high-fat semielemental diet that contained 40% more fat. The increased fat was largely in the form of medium-chain triglycerides, with the new diet providing 60% of the fat as medium-chain triglycerides compared with 40% in the standard diet. Tolerance to both diets was good in both studies. Both groups showed adequate weight gain and an improvement in anthropometric and biochemical parameters. The patients receiving the high-fat diet showed no initial weight loss, however, and their weight gain was initiated earlier. Cumulative weight gain was also higher in the group receiving the high-fat semielemental diet. Fecal fat analyses were performed after 1 week of therapy. There was no difference observed in the coefficient of fat absorption between the groups receiving the two formulas, indicating that infants with protracted diarrhea may be able to tolerate a higher fat intake than is normally provided. As carbohydrate intolerance is known to be a complicating factor when using semielemental enteral feeds for infants with protracted diarrhea, a higher-fat semielemental diet may be the most appropriate way to provide adequate caloric intake.
