Use of antioxidants to treat pain in chronic pancreatitis.

OBJECTIVE: The purpose of this report is to analyze the results of a 1-year clinical study of antioxidant therapy in the treatment of pain and recurrent inflammatory episodes in patients with chronic and acute recurrent pancreatitis, using a prospective, descriptive, pre-post, open design. The intensity of pain at the beginning and end of treatment was assessed with a visual analogue scale, and these results along with the number of hospital admissions for pancreatic disease were analyzed. METHODS: We studied patients with acute recurrent or chronic pancreatitis who had suffered from pain or acute inflammatory episodes the year before the beginning of treatment with a complex containing L-methionine, beta-carotene, vitamin C, vitamin E and organic selenium. RESULTS: Of 10 patients with chronic pancreatitis who completed treatment, the intensity of pain was reduced considerably in 9 (61.5 +/- 21.5 mm vs. 19.6 +/- 26.1 mm, p = 0.03), and pain was completely absent in 3 of these patients. Twelve patients who completed treatment had fewer hospital admissions during the year with antioxidant treatment than they had had during the previous year (1.5 +/- 1.62 vs. 0.25 +/- 0.45 admissions, p = 0.03). CONCLUSIONS: Antioxidant treatment had a positive effect in patients who suffered from pancreatic inflammatory pain, and its effectiveness should be tested before more aggressive and costlier treatments are considered.

Utilización de antioxidantes en el tratamiento del dolor de la pancreatitis crónica / use of antioxidants to treat pain in chronic pancreatitis

OBJETIVO Y MÉTODO: el propósito de este trabajo ha sido analizar los resultados clínicos obtenidos a lo largo de 1 año, con una terapéutica antioxidante, en el tratamiento del dolor y de los episodios recurrentes inflamatorios en la pancreatitis crónica y aguda recurrente, mediante el diseño de un estudio prospectivo, descriptivo, pre-post y abierto. Se valoró la intensidad del dolor al inicio y final del año de tratamiento mediante una escala analógica visual y el número de ingresos hospitalarios por motivos pancreáticos. PACIENTES: enfermos con pancreatitis crónica y aguda recurrente que habían tenido dolor o episodios inflamatorios agudos el año inmediatamente anterior al inicio del tratamiento con un complejo que contiene L-metionina, betacaroteno, vitamina C, vitamina E y selenio orgánico. RESULTADOS: 10 pacientes con pancreatitis crónica que realizaron correctamente el tratamiento, nueve obtuvieron una disminución significativa en la intensidad del dolor (61,5 ñ 21,5 mm, vs 19,6 ñ 26,1 mm; p = 0,03) (en tres desapareció por completo). Doce pacientes que realizaron correctamente el tratamiento tuvieron un número de ingresos significativamente menor el año que fueron tratados con antioxidantes al compararlos con los que tuvieron al año inmediatamente anterior (1,5 ñ 1,62 vs 0,25 ñ 0,45 ingresos; p = 0,03). CONCLUSIONES: el tratamiento antioxidante influye favorablemente en un número no despreciable de pacientes con dolor de origen inflamatorio pancreático y debe probarse su utilidad antes de decidirse por otros tratamientos más agresivos y costosos (AU)

[Domiciliary intravenous antibiotic therapy]. / Antibioterapia intravenosa domiciliaria.

BACKGROUND: To assess the efficiency and safety of intravenous antibiotic therapy (IAT) when performed through the traditional simple infusion system by gravity in the home setting. PATIENTS AND METHODS: The clinical records of patients undergoing intravenous antibiotic therapy through the traditional gravitational infusion system in the home care unit over a five year period were reviewed retrospectively. RESULTS: 120 patients were treated (44 F/76 M), with a mean age of 48 years (44-52). 67% of the total had chronic diseases. Infections were most commonly found in bones and joints (38%), followed by the skin and soft tissues. A wide variety of antibiotics was used, 61% as monotherapy. 76% of them were given intermittently. 161 intravenous catheters were used, 53% of which were central catheters with peripheral insertion, 27% inserted centrally and 20% peripheral catheters. The overall incidence of phlebitis was 18% without associated bacteremia. 91% of our patients evolved well, 6% had to become in-patients, none of them due to problems with the infusion system or by their own petition. The intravenous treatment lasted a mean of 17 days at home and 25 days at both home and hospital, which represents a decrease of 2,040 hospital stays. CONCLUSIONS: The traditional gravitational system of infusion is an effective and safe method for intravenous antibiotic administration at home. For these therapies to be successful, suitable patients must be selected and continuous attention is required. This treatment at home satisfies the patient and permits hospital stays to be reduced, thus improving the use of hospital resources.