ABSTRACT
Objetivo: Evaluar si un nuevo protocolo de terapia en espejo (MT, por sus siglas en inglés) es efectivo para provocar cambios analgésicos en pacientes afectados por dolor central posterior al accidente cerebrovascular (CPSP, por sus siglas en inglés). Materiales y métodos: Tres pacientes con CPSP fueron evaluados sobre la intensidad percibida de los síntomas del dolor neuropático, su interferencia con las actividades cotidianas, el nivel de ansiedad y en el desempeño del entrenamiento para la discriminación de lateralidad. Dentro de un intervalo de 3 semanas se realizaron 15 sesiones de MT progresivas, con mediciones pre-postratamiento, y a una semana de seguimiento. Resultados: En los 3 casos, el protocolo de intervención mejoró la sintomatología neuropática (reducción de dolor: 11,3 puntos; DE: 3,1), su interferencia con actividades cotidianas (reducción de: 10 puntos; DE: 2) y el desempeño en discriminación de lateralidad (aumento de aciertos: 13%; DE: 18,1) al postratamiento y manteniéndose estables al seguimiento. Sin embargo, la mejoría para ansiedad no fue relevante. Conclusiones: Este estudio piloto sugiere resultados prometedores con relación a la MT, así como buena tolerancia y seguridad. Futuros estudios podrían explorar la efectividad de este protocolo con un mayor número de pacientes y proponer estrategias sinérgicas para potenciar los efectos analgésicos
Objective: To determine whether a novel mirror therapy (MT) protocol effectively led to analgesic changes in patients suffering from Central Post-Stroke Pain (CPSP). Materials and methods: Three patients were identified with CPSP and assessed in perceived intensity of neuropathic pain symptoms, interference with activities of daily living, anxiety level, and laterality discrimination training performance. Each participant received 15 sessions of progressive MT within a three-week interval, and assessed at pre-post treatment, and at 1-week follow-up. Results: The intervention-protocol improved the neuropathic symptoms in all 3 cases (pain reduction: 11.3 points; SD: 3.1), interference with activities of daily living, (reduction of: 10 points; SD: 2), and an increase in laterality discrimination accuracy (13%; SD: 18.1) at post-treatment, which maintained stable at follow-up in the three cases. However, anxiety levels did not show any significant improvement. Conclusions: This pilot-study suggests promising results in the application of MT, including good tolerance and safety. Future studies should examine the effectiveness of the protocol with a larger sample size and propose synergic strategies to enhance analgesic effects
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Shock/complications , Shock/therapy , Stroke Rehabilitation/methods , Chronic Pain/therapy , Physical Therapy Modalities , Pain Measurement/methods , Pain ManagementABSTRACT
Revisión de evidencia y opciones terapéuticas del factor de crecimiento epidérmico recombinante humano bioidéntico (rhEGF) en úlceras vasculares. El rhEGF ha evidenciado eficacia, tolerabilidad y seguridad, considerándose tratamiento adyuvante o emergente en guías de práctica clínica basadas en la evidencia. Se dispone de rhEGF mediante formulación magistral, asegurando estabilidad, efectividad y seguridad, permitiendo la individualización (adición de principios activos, cambios de galénica). Los compuestos con rhEGF mediante formulación magistral pueden considerarse indicados en el tratamiento de úlceras vasculares
Review of scientific evidence and therapeutic options of recombinant human bioidentical epidermal growth factor (rhEGF) for vascular ulcers. Efficacy, with excellent tolerability and safety has been demonstrated with rhEGF, and it has been considered as an adjuvant or emerging treatment in evidence based clinical practice guidelines. rhEGF is available by magistral prescription, ensuring stability, effectiveness and safety, allowing individualisation (addition of active principles or dose personalisation). Compounds with rhEGF can be considered for managing vascular ulcers
Subject(s)
Humans , Male , Female , Leg Ulcer/therapy , Bandages , Biological Dressings/classification , Biological Dressings/standards , Biological Dressings , Recombination, Genetic/physiology , Epidermal Growth Factor/metabolism , Epidermal Growth Factor/therapeutic use , Epidermal Growth Factor/administration & dosage , Epidermal Growth Factor/deficiency , Anti-Ulcer Agents/therapeutic use , Silicones/therapeutic useABSTRACT
Chyluria is a consequence of the aperture of one or more perirenal lymphatic vessels to the renal pelvis, and is characterized by milky urine, rich in protein, lipids, cholesterol and triglycerides. Where there is chyluria there is malformation of the chyliferous vessels of the small intestine associated to hypoplasia of Pecquet's cistern. A 22 year old patient who had had persistent chyluria since the age of 16 is presented with a test of induced hyperlipidemia typical of intestinal lymphatic malformation. Chyluria was demonstrated by lymphography by bilateral pedial approach and ascending pyelography. Following surgical ligation of the lymphatic vessels of the left kidney the chyluria remitted and the patient has had no further clinical manifestation up to the present, one year after surgery.
