ABSTRACT
OBJECTIVE: Evaluate the efficacy of acupuncture associated with physiotherapy for patients with painful shoulder. METHODS: In a multicentre controlled randomized study, participants were recruited with a clinical diagnosis of unilateral subacromial syndrome from six rehabilitation medicine departments belonging to the Public Health System in two Spanish regions. All participants received 15 sessions of physiotherapy during the 3 weeks that the treatment lasted and were randomized to additionally receive, once a week, acupuncture or mock TENS (transcutaneous electrical nerve stimulation). The primary outcome measure was the change in the Constant-Murley Score (CMS) for functional assessment of the shoulder, at 4 weeks after randomization. This study is registered as an International Standard Randomized Controlled Trial, number ISRCTN28687220. RESULTS: A total of 425 patients were recruited. The mean score (s.d.) on the CMS had increased by 16.6 (15.6) points among the acupuncture group, compared with 10.6 (13.5) points in the control group, and the mean difference between the two groups was statistically significant (6.0 points; 95% CI 3.2, 8.8 points; P < 0.001). By the end of the treatment, 53% of the patients in the acupuncture group had decreased their consumption of analgesics, compared with a corresponding 30% among the control group (P < 0.001). CONCLUSIONS: Single-point acupuncture in association with physiotherapy improves shoulder function and alleviates pain, compared with physiotherapy as the sole treatment. This improvement is accompanied by a reduction in the consumption of analgesic medicaments.
Subject(s)
Acupuncture Therapy/methods , Physical Therapy Modalities , Shoulder Impingement Syndrome/therapy , Shoulder Pain/therapy , Acupuncture Points , Acupuncture Therapy/adverse effects , Adult , Aged , Analgesics/administration & dosage , Anti-Inflammatory Agents/administration & dosage , Combined Modality Therapy , Drug Administration Schedule , Female , Humans , Male , Middle Aged , Pain Measurement/methods , Physical Therapy Modalities/adverse effects , Severity of Illness Index , Shoulder Impingement Syndrome/physiopathology , Shoulder Joint/physiopathology , Shoulder Pain/physiopathology , Single-Blind Method , Treatment OutcomeSubject(s)
alpha-Mannosidosis/diagnosis , Child, Preschool , Diagnosis, Differential , Health Status , Humans , Male , Phenotype , Severity of Illness IndexSubject(s)
Brain Neoplasms , Neoplasms, Neuroepithelial , Adolescent , Brain Neoplasms/diagnosis , Brain Neoplasms/pathology , Brain Neoplasms/physiopathology , Child , Female , Humans , Infant , Magnetic Resonance Imaging , Neoplasms, Neuroepithelial/diagnosis , Neoplasms, Neuroepithelial/pathology , Neoplasms, Neuroepithelial/physiopathology , Retrospective StudiesABSTRACT
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Subject(s)
Humans , Female , Infant , Child , Adolescent , Teratoma/diagnosis , Neuroectodermal Tumors, Primitive, Peripheral/diagnosis , Neuroglia/pathology , Epilepsies, Partial , NeuroimagingABSTRACT
El edema agudo hemorrágico infantil (EAHI) es una vasculitis leucocitoclástica caracterizada por el desarrollo agudo de lesiones purpúricas en medallón sobre áreas de edema en la cara, los pabellones auriculares y las extremidades. Habitualmente, afecta a niños menores de 2 años y cursa con febrícula y buen estado general, siendo excepcional la afectación sistémica. Esta entidad no ha sido reconocida en todo el mundo, y hay ciertas controversiass obre si se trata de una variante de la púrpurade Henoch-Schonlein o tiene un origen diferente. Presentamos 5 casos diagnosticados de EAHI en nuestro centro en el periodo comprendido entre marzo de 2004 y marzo de 2005, así como una revisión de la bibliografía disponible al respecto
Acute hemorrhagic edema of infancy (AHEI) is a cutaneous leukocytoclastic vasculitis characterized by acute development of tender rosette-like purpuric lesions within edematous areas on the face, ears and limbs. It usually affects children up to two years of age and is characterized by low-grade fever and a good general condition. Systemic involvement is unusual. The origin of this disease is a matter of controversy, and it has been postulated to be a clinical variant of Henoch-Schonlein purpura. We report five cases of AHEI in our center occurring between March 2004 and March 2005 and provide a review of the literature
Subject(s)
Male , Female , Infant , Humans , Hemorrhagic Disorders/diagnosis , Vasculitis, Leukocytoclastic, Cutaneous/diagnosis , IgA Vasculitis/diagnosis , Diagnosis, Differential , Edema/complicationsABSTRACT
Se presentan los resultados obtenidos tras 18 años de experiencia en autotrasplante de caninos superiores incluidos. Se explican en detalle las indicaciones, técnica quirúrgica y resultados, concluyendo que a la vista de éstos, la manipulación quirúrgica de caninos retenidos sanos tiene un alto porcentaje de éxito a largo plazo
We present the result obtained during our 18 years of experience in autotransplantation of upper canines. Detailed explanation is given regarding the surgical indications, techniques indications, tecniques an results, In view of this, a conclusion is reached regarding the high, long-term sucess rate of surgical manipulation of embedded, healthy canines
Subject(s)
Male , Female , Adult , Adolescent , Humans , Tooth, Impacted/surgery , Tooth, Unerupted/transplantation , Cuspid/transplantation , Transplantation, Autologous/methods , Graft SurvivalABSTRACT
Presentamos los resultados obtenidos tras 17 años de experiencia en el tratamiento quirúrgico de las malposiciones dentales. Se incluyen los autotrasplantes de molares incluidos, autotrasplantes de caninos retenidos y reubicación de incisivos, caninos o premolares mal posicionados; 81 piezas dentales en total, de los cuales 60 dientes corresponden a autotrasplantes y 21 a reubicaciones, obteniendo un alto porcentaje de éxito. Se explica en detalle las indicaciones, técnica quirúrgica y resultados, concluyendo en que a la vista de los mismos, la manipulación quirúrgica de dientes retenidos sanos tiene un alto porcentaje de éxito a largo plazo (AU)
Subject(s)
Adolescent , Adult , Female , Male , Humans , Transplantation, Autologous/methods , Microscopy/methods , Orthodontics/methods , Periodontal Splints , Occlusal Splints , Malocclusion/surgery , Malocclusion/diagnosisABSTRACT
Objetivos: Identificar y cuantificar los métodos estadísticos utilizados en los artículos originales publicados en la revista Rehabilitación en los últimos 10 años. Realizamos una comparación de la utilización de estadística en dos períodos 1989-1994 y 1995-1999.Diseño: Estudio descriptivo. Métodos: Todos los artículos originales publicados en la revista Rehabilitación en los últimos 10 años, fueron revisados por dos investigadores independientes para identificar y cuantificar el uso de los métodos estadísticos utilizados. Resultados: De los 376 artículos originales analizados, 238 (63 por ciento) corresponden al primer período (1989-1994) y 138 (37 por ciento) al segundo período (1994-1999). El 59 por ciento eran estudios retrospectivos, el 39 por ciento prospectivos y el 2 por ciento tras la lectura no podíamos determinar si habían sido prospectivos o retrospectivos. En 214 artículos (57 por ciento) solo se utilizó estadística descriptiva (porcentajes) y en los 162 restantes (43 por ciento) se emplearon una o más de una técnica estadística (AU)
Subject(s)
Statistics as Topic , Rehabilitation , 28599 , LiteratureABSTRACT
Objetivos: Identificar y describir los ensayos clínicos aleatorizados, publicados en la revista Rehabilitación entre los años 1989-1999. Métodos: Todos los artículos originales publicados en ese período, fueron revisados por dos investigadores independientes y se distribuyeron en cinco grupos: Ensayos Clínicos, estudios básico-experimentales con animales de laboratorio, epidemiológicos, clínico-diagnósticos y otros. Se realizó una descripción de los ensayos clínicos (estudios experimentales en seres humanos). Resultados: Se identificaron 376 artículos originales, de los cuales 44 (12 por ciento) eran del grupo ensayo clínico, 13 (3 por ciento) investigación básica-experimental con animales de laboratorio, 256 (58 por ciento) epidemiológicos, 42 (11 por ciento) clínico-diagnóstico y 21 (6 por ciento) incluidos en otros. El 60 por ciento pertenecen al primer período y el 40 por ciento al segundo. Aleatorizado 20 por ciento, controlado 43 por ciento, enmascaramiento 9 por ciento, consentimiento informado 5 por ciento, con fármacos el 25 por ciento, más de 50 participantes el 30 por ciento. Conclusión: Se realizan y publican pocos ensayos clínicos en nuestra especialidad y encontramos graves deficiencias en la información comunicada (AU)
Subject(s)
Rehabilitation/statistics & numerical data , Clinical Trials as Topic/statistics & numerical data , Periodicals as Topic , Peer Review/standardsABSTRACT
Las patologías inflamatorias y calcificantes de las partes blandas son trastornos con importante repercusión económica y social. Su tratamiento puede realizarse con fármacos o con terapia física, ante cuyo fracaso, la cirugía era el último escalón terapéutico existente. En los últimos años se está utilizando una alternativa no quirúrgica para tratarlas, la aplicación de ondas de choque extracorpóreas de modo similar al empleado en urología para el tratamiento de la litiasis renal. El objetivo de este trabajo fue comprobar la capacidad para disminuir el dolor con esta técnica terapéutica y definir las pautas de aplicación. Tratamos a 18 pacientes con patología de hombro (tendinitis calcificante), epicondilitis y talalgia. Los resultados se evaluaron por la escala analógica visual de dolor, la escala de Constant y por la radiología, antes del tratamiento, y a los tres meses, seis meses y 18 meses de finalizarlo. El tratamiento fue efectivo en 12 de los 18 pacientes. Concluimos que agotadas las medidas terapéuticas médicas y de terapia física, el tratamiento con ondas de choque extracorpóreas es una buena alternativa al empleo de la cirugía (AU)
Subject(s)
Adult , Female , Male , Middle Aged , Humans , Lithotripsy/methods , Lithotripsy , Tennis Elbow/therapy , Pain/therapy , Tendinopathy/therapy , Pain Measurement , Treatment Outcome , Follow-Up StudiesABSTRACT
Sump syndrome consists on an entity in which the distal portion of the biliary tree does not drainage by the major papilla, so food and bile are retained and infections could appear leading to cholangitis. The real incidence of the sump syndrome after side-to-side choledocoduodenostomy is unknown, but has been described less than 10%. Several procedures have been used to solve it but at present endoscopic sphincterotomy is of choice the treatment of this condition that is followed by a good outcome. When major papilla can not be negotiated, an endoscopic approach consisting in a biliary endoscopic <
Subject(s)
Postcholecystectomy Syndrome/therapy , Aged , Bile Ducts , Endoscopy, Digestive System , Humans , MaleABSTRACT
A case of small-cell carcinoma of the larynx was diagnosed in a 65-year-old man whose only symptom was voice change. Two cervical lymph nodes were present. Indirect laryngoscopy demonstrated a smooth-surfaced mass on the lingual face of the epiglottis, which was confirmed by CAT of the larynx and throat. Histological study was consistent with small-cell carcinoma, is a rare neuroendocrine tumor for this site. The therapeutic strategy is described. A bibliographic review was made to clarify reports of these rare tumors using different nomenclature and classifications.
Subject(s)
Carcinoma, Neuroendocrine/pathology , Laryngeal Neoplasms/pathology , Larynx/pathology , Aged , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/therapeutic use , Carcinoma, Neuroendocrine/drug therapy , Humans , Laryngeal Neoplasms/drug therapy , Male , Tomography, X-Ray ComputedABSTRACT
Presemtamos un estudio realizado en 10 autotransplantes de caninos incluidos, colocados en neoalvéolos y puestos en función. El caso más antiguo lleva seis años de evolución y ninguno de ellos se ha perdido hasta el momento. Es un procedimiento poco usado y prácticamente inutilizado desde la llegada de los implantes oseointegrados. Creemos firmemente que en casos bien seleccionados este método es de elección sobre todos los demás
Subject(s)
Adult , Humans , Male , Female , Cuspid/surgery , Surgery, Oral/methods , Tooth Extraction/instrumentation , Dental ImplantsABSTRACT
We described a case of endobronchial hamartoma diagnosed in a seven years-old-child (which presented with chronic cough as the only symptom). The chest radiographs showed left lung global condensation. We did rigid bronchoscopy to discard a bronchial foreign body and confirmed the existence of a white-yellowish colour, smooth surface mass obliterating the left main bronchus. Biopsy and anatomopathology study give the result of hamartoma. We performed thoracotomy, bronchotomy and enucleation of the mass. The frequency, clinic, diagnosis and treatment of endobronchial hamartoma are analyzed.
Subject(s)
Bronchi/pathology , Bronchial Neoplasms/pathology , Hamartoma/diagnosis , Bronchi/surgery , Bronchial Neoplasms/diagnosis , Bronchial Neoplasms/surgery , Bronchography , Child , Fatal Outcome , Hamartoma/pathology , Hamartoma/surgery , Humans , MaleABSTRACT
A 28-year-old female, diagnosed two years ago of euthyroid lingual thyroid, has been asymptomatic under observation without treatment until her first pregnancy. During her first pregnancy the lingual thyroid tissue increases of size and produces dysphagia, pain and oral hemorrhages. We realize a thyroid hormone treatment (thyroxine) with regular results. Two months after child-birth the female was completely asymptomatic and doesn't need actually thyroxine suppression. Various aspects are reviewed, such as the predisposing factors (puberty, pregnancy, trauma ...), clinical manifestations, diagnosis and medical and surgical treatments in this rara congenital anomaly.
Subject(s)
Choristoma/diagnosis , Pregnancy Complications, Neoplastic/diagnosis , Thyroid Gland/pathology , Tongue Neoplasms/diagnosis , Adult , Female , Humans , Hypertrophy , PregnancyABSTRACT
In this study we presents: 6 subglottic stenosis, 2 subglottic hemangiomas, 2 laryngeal webs, 2 laryngeal cysts and 1 laryngoesophageal cleft. Were diagnosed during laryngotracheobronchoscopies performed to 220 newborns and small children that showed as main finding: stridor, voice change or aspiration syndrome. The stenosis, hemangiomas and cleft were resolved spontaneously. In the webs and cysts surgical correction was required. Here we will expound upon clinical, diagnostical and therapeutic aspects of these rare congenital laryngeal anomalies.
Subject(s)
Laryngeal Diseases/congenital , Larynx/abnormalities , Congenital Abnormalities/therapy , Female , Humans , Infant, Newborn , Laryngeal Diseases/therapy , MaleABSTRACT
Were performed 220 direct laryngoscopys and bronchoscopys, from 1981 to 1990, in newborns and infants that showed as a main finding: stridor, voice change or aspiration syndromes. Fourteen (20.28%) of the 69 congenital laryngeal anomalies were vocal cord paralysis: 13 (92.8%) unilateral paralysis and 1 (7.2%) bilateral paralysis. Eleven (84.6%) of the 13 unilateral paralysis were left and 2 (15.4%) were right. The vocal cord position was noted to be median or paramedian in 13 (92.8%) patients. The etiology was idiopathic in 11 (78.5%) of the cases. The bilateral paralysis required tracheotomy and in the unilateral paralysis wasn't necessary it.
Subject(s)
Vocal Cord Paralysis/congenital , Female , Humans , Infant , Infant, Newborn , Male , Vocal Cord Paralysis/complications , Vocal Cord Paralysis/therapyABSTRACT
In the period from 1981 to 1990, in the Children's Hospital from Sevilla were performed 220 direct laryngoscopies and bronchoscopies to newborns and infants that showed as a main finding: stridor voice change or aspiration syndromes. In the 30 percent the main cause was a congenital laryngeal anomalies. Laryngomalacia is the most common congenital laryngeal anomaly with 42 cases. For it frequency, the otolaryngologist should be familiar with the clinical findings, diagnosis and actual management.