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1.
Phys Med Rehabil Clin N Am ; 35(2): 399-418, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38514226

RESUMO

Botulinum toxin (BonT) is the mainstream treatment option for post-stroke spasticity. BoNT therapy may not be adequate in those with severe spasticity. There are a number of emerging treatment options for spasticity management. In this paper, we focus on innovative and revived treatment options that can be alternative or complementary to BoNT therapy, including phenol neurolysis, cryoneurolysis, and extracorporeal shock wave therapy.


Assuntos
Toxinas Botulínicas Tipo A , Fármacos Neuromusculares , Acidente Vascular Cerebral , Humanos , Toxinas Botulínicas Tipo A/uso terapêutico , Fármacos Neuromusculares/uso terapêutico , Resultado do Tratamento , Espasticidade Muscular/tratamento farmacológico , Espasticidade Muscular/etiologia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/tratamento farmacológico
2.
Nefrología (Madrid) ; 42(6): 704-713, nov.-dic. 2022. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-212600

RESUMO

Antecedentes y objetivo: La diabetes mellitus es la principal causa de enfermedad renal crónica (ERC) en nuestro país. El objetivo fue estimar la prevalencia global y por áreas sanitarias de ERC en la población diabética de Extremadura. Pacientes y métodos: Estudio observacional, longitudinal, retrospectivo en la población diabética atendida en el Sistema Extremeño de Salud durante el periodo 2012-2014. Se incluyeron 90.709 pacientes ≥ 18 años. El cálculo del filtrado glomerular estimado (FGe) se realizó mediante la ecuación CKD-EPI (derivada de la ecuación desarrollada por la Chronic Kidney Disease Epidemiology Collaboration) y se calculó el cociente albúmina/creatinina en orina (CAC). Se consideró paciente con ERC a todo aquel que en su última analítica tenía un FGe<60 mL/min/1,73 m2 y/o un CAC ≥ 30 mg/g, confirmados en una determinación previa separada al menos por tres meses. Resultados: La prevalencia global de ERC fue del 15,6% (17,5% en mujeres y 13,7% en varones) y fue mayor en la provincia de Cáceres (17%) que en la de Badajoz (14,8%, p<0,001), encontrándose la menor prevalencia en el área sanitaria de Navalmoral de la Mata (13%) y la mayor en la de Plasencia (17,8%, p < 0,001). La prevalencia de ERC definida sin necesidad de confirmación de la sostenibilidad del daño renal o del FGe disminuido fue del 26,1% (29,3% en mujeres y 22,9% en varones), lo que supone una sobreestimación de la prevalencia del 67%. Conclusiones: La prevalencia de ERC en población diabética extremeña es menor a la referida habitualmente y difiere significativamente entre sus áreas sanitarias. (AU)


Background and objective: Diabetes mellitus is the leading cause of chronic kidney disease (CKD) in our country. The objective was to estimate the global prevalence and by health areas of CKD in the diabetic population of Extremadura. Patients and methods: Observational, longitudinal retrospective study in the diabetic population attended in the Extremadura Health System in 2012–2014. A total of 90,709 patients ≥ 18 years old were studied. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI). The presence of CKD was defined as follows: an eGFR<60 mL/min/1.73 m2 in a time period of greater than three months or the presence of renal damage, as evaluated by an urine albumin-creatinine ratio (UACR) ≥ 30 mg/g, with or without reduced eGFR, also in a time period of greater than three months. Results: The overall prevalence of CKD was 15.6% (17.5% in women and 13.7% in men) and it was higher in the province of Cáceres (17%) than in Badajoz (14.8%, p<0.001), with the lowest prevalence in the Navalmoral de la Mata health area (13%) and the highest in Plasencia (17.8%, p<0.001). The prevalence of CKD defined without the need for confirmation of the sustainability of kidney damage or decreased eGFR was 26.1% (29.3% in women and 22.9% in men), which represents an overestimation of the prevalence of 67%. Conclusions: The prevalence of CKD in Extremadura's diabetic population is lower than usually referred to and differs significantly between its health areas. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Insuficiência Renal Crônica , Diabetes Mellitus , Estudos Retrospectivos , Estudos Longitudinais , Albuminúria , Atenção Primária à Saúde
3.
Nefrologia (Engl Ed) ; 42(6): 704-713, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36858876

RESUMO

BACKGROUND AND OBJECTIVE: Diabetes mellitus is the leading cause of chronic kidney disease (CKD) in our country. The objective was to estimate the global prevalence and by health areas of CKD in the diabetic population of Extremadura. METHODS: Observational, longitudinal retrospective study in the diabetic population attended in the Extremadura Health System in 2012-2014. A total of 90,709 patients ≥18 years old were studied. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI). The presence of CKD was was defined as follows: an eGFR <60ml/min/1.73m2 in a time period≥of three months or the presence of renal damage, as evaluated by an urine albumin-creatinine ratio (UACR) ≥30mg/g, with or without reduced eGFR, also in a time period ≥ of three months. RESULTS: The overall prevalence of CKD was 15.6% (17.5% in women and 13.7% in men) and it was higher in the province of Cáceres (17.0%) than in Badajoz (14.8%, p<0.001), with the lowest prevalence in the Navalmoral de la Mata health area (13.0%) and the highest in Plasencia (17.8%, p<0.001). The prevalence of CKD defined without the need for confirmation of the sustainability of kidney damage or decreased eGFR was 26.1% (29.3% in women and 22.9% in men), which represents an overestimation of the prevalence of 67%. CONCLUSIONS: The prevalence of CKD in Extremadura's diabetic population is lower than usually referred to and differs significantly between its health areas.


Assuntos
Diabetes Mellitus , Insuficiência Renal Crônica , Masculino , Humanos , Feminino , Adolescente , Estudos Retrospectivos , Prevalência , Insuficiência Renal Crônica/epidemiologia , Diabetes Mellitus/epidemiologia , Testes de Função Renal
4.
J Neurol Sci ; 425: 117449, 2021 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-33878656

RESUMO

Our primary objective was to compare early-start vs. late-start Botulinum toxin (BoNT) injections in post-stroke spasticity management. This is an IRB approved retrospective chart review of patients who were admitted for inpatient rehabilitation within 6 months after first-ever stroke between January 2014 and December 2018 and received BoNT injections within 15 months. The total dose and interval between consecutive injections were used as objective outcomes. 2367 stroke admissions were reviewed. 189 patients metinclusion criteria. 68 out of 189 patients received BoNT injections within 12 weeks after stroke (EARLY group). 20 patients in the EARLY group who received at least three cycles were included for analysis. Out of 189 patients, 47 patients were categorized into the Early- and Late-start subgroups each by time from stroke onset to first BoNT injection (1st and 4th quartiles of time distribution) for comparisons. In the EARLY group, the first interval (Mean (M) = 7.6 weeks, standard deviation (SD) = 2.14) was significantly shorter than the second interval (M = 23.7, SD = 10.41) and the third interval (M = 20.0, SD = 11.23; p < 0.05). The dose at the first cycle (M = 492 units, SD = 201.5) was significantly lower than the dose at the third cycle (M = 605, SD = 82.6). In comparison between the Early- and Late-start subgroups, the time to first BoNT injection was 6.4 weeks (range: 4.7-8.6) after stroke for the Early-start subgroup and 49.6 weeks (range: 27.4-62.3) after stroke for the Late-start subgroup. The subsequent intervals after the first injection were significantly longer in the Early-start subgroup (M = 23.1 weeks) than in the Late-start subgroup (M = 14.6 weeks) (p = 0.008). The average total dose of BoNT was significantly higher in the Early-start subgroup (M = 561.9 units, SD = 143.1) than the Late-start subgroup (M = 470.0, SD = 164.8) (p = 0.012). The findings showed that higher doses of BoNT were used in the Early-start group, and often resulted in longer intervals between subsequent injections than in the Late-start group.


Assuntos
Toxinas Botulínicas Tipo A , Fármacos Neuromusculares , Acidente Vascular Cerebral , Toxinas Botulínicas Tipo A/uso terapêutico , Humanos , Injeções Intramusculares , Espasticidade Muscular/tratamento farmacológico , Espasticidade Muscular/etiologia , Fármacos Neuromusculares/uso terapêutico , Estudos Retrospectivos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/tratamento farmacológico , Resultado do Tratamento
5.
Rev Esp Salud Publica ; 952021 Feb 16.
Artigo em Espanhol | MEDLINE | ID: mdl-33589582

RESUMO

OBJECTIVE: Compliance with the therapeutic objectives recommended in the clinical practice guidelines on cardiovascular prevention and changes in lifestyle, such as smoking cessation, reduce the morbidity and mortality of patients with ischemic heart disease. The objective of this study was to analyze the prevalence and degree of control of the main cardiovascular risk factors in patients with ischemic heart disease. METHODS: A total of 200 patients with ischemic heart disease randomly selected between the years 2008-2018. The degree of control of the cardiovascular risk factors and the achievement of the recommended objectives in secondary cardiovascular prevention were analyzed during a mean follow-up of 5 years. A descriptive and inferential analysis of the data was performed with the SPPS version 22.0 program. RESULTS: 77.9% of patients (mean age 65.6 years, 63.2 men and 70.5 women, p<0.01) had high blood pressure, 69.3% dyslipidemia, 48.2% obesity and 32.3% diabetes. 34.8% were smokers (39.2% of men versus 25.4% of women, p=0.06). During the follow-up, a slight decrease in smoking was observed (from 34.8% to 21.6%, p<0.01), with a greater percentage reduction in men versus women (42.9% versus 21.3%, p<0.01). In the follow-up, he also highlighted the decrease in blood pressure, total cholesterol and LDL-cholesterol. Optimal compliance with therapeutic objectives was achieved in 21.7% of patients. CONCLUSIONS: The objectives of secondary cardiovascular prevention are reached in a low percentage of patients with ischemic heart disease, with a lower rate of smoking cessation in women.


OBJETIVO: El logro de objetivos terapéuticos recomendados en las guías de práctica clínica sobre prevención cardiovascular y los cambios en estilos de vida, como abandono del tabaco, disminuyen la morbimortalidad de los pacientes con cardiopatía isquémica. El objetivo de este estudio fue analizar la prevalencia y grado de control de los principales factores de riesgo cardiovascular en pacientes con cardiopatía isquémica. METODOS: La muestra la conformó un total de 200 pacientes con cardiopatía isquémica seleccionados aleatoriamente entre los años 2008-2018. Se analizó el grado de control de los factores de riesgo cardiovascular y el logro de los objetivos recomendados en prevención secundaria cardiovascular, durante un seguimiento medio de 5 años. Se realizó un análisis descriptivo e inferencial de los datos con el programa estadístico SPPS versión 22.0. RESULTADOS: Un 77,9% de los pacientes (edad media 65,6 años; 63,2 años los varones y 70,5 las mujeres, p<0,01) presentaban hipertensión arterial, un 69,3% dislipemia, un 48,2% obesidad y un 32,3% diabetes. El 34,8% eran fumadores (el 39,2% de los varones frente al 25,4% de las mujeres, p=0,06). Durante el seguimiento destacó el discreto descenso del tabaquismo (del 34,8% al 21,6%, p<0,01), con una mayor caída porcentual en los varones frente a las mujeres (42,9% versus 21,3%, p<0,01). También destacó la disminución de las cifras de presión arterial, colesterol total y LDL-colesterol. El cumplimiento óptimo de los objetivos terapéuticos se logró en el 21,7% de los pacientes. CONCLUSIONES: Los objetivos de prevención secundaria cardiovascular se alcanzan en un bajo porcentaje de los pacientes con cardiopatía isquémica, con una menor tasa de abandono del tabaquismo en mujeres.


Assuntos
Isquemia Miocárdica/epidemiologia , Isquemia Miocárdica/prevenção & controle , Serviços Urbanos de Saúde , Idoso , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Espanha/epidemiologia
6.
Front Rehabil Sci ; 2: 729178, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-36188807

RESUMO

The main objective was to examine practice patterns of phenol neurolysis for post-stroke spasticity management in the early stage. We performed a chart review of patients who were admitted for inpatient rehabilitation within 6 months after first-ever stroke and received phenol neurolysis within 15 months post-stroke. Out of 2,367 stroke admissions from January 2014 and December 2018, 68 patients met the criteria. 52.9% of these patients received phenol neurolysis within 12 weeks, i.e., early stage. The earliest phenol neurolysis procedure was at 19 days after stroke. On average, patients received first phenol injections at 16.3 weeks after stroke with an average dose of 7.3 ml. Most commonly injected nerves were tibial nerve motor branches (41/68), sciatic nerve motor branches (37/68), lateral pectoral nerve (16/68), medial pectoral nerve (15/68), obturator nerve (15/68) and musculocutaneous nerve (15/68). Among 68 patients, 24 received phenol only; 17 received phenol neurolysis first followed by botulinum toxin (BoNT) injections; 19 received BoNT injections first followed by phenol neurolysis; 8 received both phenol and BoNT injections at the same time. The interval from stroke to first procedure was similar between the Phenol-First group (13.3 weeks) and the BoNT-First group (12.6 weeks). The total amount of BoNT was significantly lower in the Phenol-First group (361.3 units) than in the BoNT-First group (515.8 units) (p = 0.005). The total amount of phenol was not statistically different between the Phenol-First group (5.9 ml) and the BoNT-First group (8.3 ml). The interval between the first procedure and its subsequent procedure was not statistically different between the Phenol-First group (18.3 weeks) and the BoNT-First group (10.7 weeks). These long intervals suggest that the subsequent injection (type and dose) was not planned during the first procedure. The general patterns of target areas were similar between BoNT injections and phenol neurolysis, except that phenol neurolysis rarely targeted the upper extremity distal muscles. No side effects after phenol or BoNT injections in the early stage after stroke were observed in the chart review. In summary, phenol neurolysis was started as early as 19 days after stroke. On average, patients received first phenol about 4 months after stroke with an average of 7.3 ml of phenol. Early use of phenol neurolysis likely decreases the total amount of BoNT for management of post-stroke spasticity without increased side effects.

8.
Curr Phys Med Rehabil Rep ; 8(4): 452-460, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33777503

RESUMO

PURPOSE OF REVIEW: to evaluate recent scientific research studies related to the changes in skeletal muscle after stroke and the presence of sarcopenia in stroke survivors to establish its incidence and effects on function. RECENT FINDINGS: Recently published findings on stroke-related sarcopenia are limited. This might be due to changes in the consensus definition of sarcopenia. Sarcopenia in stroke patients is estimated at 14 to 54%. The presence of sarcopenia at the time of a stroke can lead to worse recovery and functional outcomes. SUMMARY: Presence of sarcopenia prior to a stroke may be more common than suspected and can lead to worse functional recovery. Clinicians should be aware of this to better identify and treat stroke-related sarcopenia. Future research should focus on larger population studies to more accurately establish correlation between stroke and sarcopenia.

11.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 45(4): 232-238, mayo-jun. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-188075

RESUMO

INTRODUCCIÓN: En la valoración inicial de un paciente con cefalea, el médico se plantea con frecuencia si el dolor se corresponde con una migraña y si el paciente precisa pruebas de neuroimagen. El objetivo del trabajo fue valorar la validez y aplicabilidad de la regla nemotécnica POUNDing en pacientes diagnosticados de migraña. PACIENTES Y MÉTODOS: Estudio descriptivo, de aplicación de la regla POUNDing en pacientes con diagnóstico de migraña y con realización de alguna prueba de imagen cerebral (tomografía computarizada o resonancia magnética), en un centro de salud urbano y en una consulta de Neurología del Hospital Universitario de Badajoz. RESULTADOS: Se incluyó a 116 pacientes (edad media 45,6 años; 79,3% mujeres; 70 procedentes de consultas de Neurología y 46 del centro de salud). Destacaron en las comparaciones los elevados valores predictivos positivos: 90,9% (IC 95%: 57,1-99,5%); 100% (IC 95%: 73,2-99,3%) y 96,0% (IC 95%: 77,7-99,8%), en los pacientes de la consulta de Neurología, del centro de salud y en la población total, respectivamente, y sus bajos valores predictivos negativos: 6,8% (IC 95%: 2,2-17,3%); 3,1% (IC 95%: 0,2-18,0%) y 5,5% (IC 95%: 2,0-12,9%), también respectivamente en los pacientes de la consulta de Neurología, del centro de salud y en la población total. CONCLUSIONES: La regla POUNDing presenta un alto valor predictivo positivo y podría ser de gran ayuda en la aceptación o rechazo de un diagnóstico de migraña, al facilitar un uso más eficiente de las pruebas de neuroimagen


INTRODUCTION: In assessing the patient with headache, clinicians are often faced with 2 important questions: Is this headache a migraine? Does this patient require neuroimaging? The aim of this study was to assess the validity and applicability of the mnemonic POUNDing rule in patients diagnosed with migraine. PATIENTS AND METHODS: A descriptive, validation study of the POUNDing rule in patients with a diagnosis of migraines and with a brain imaging test (computed tomography or magnetic resonance imaging), in an urban health centre and a neurology clinic of the University Hospital of Badajoz. RESULTS: A total of 116 patients were included (mean age 45.6 years; 79.3% women, 70 from the neurology clinics, and 46 from the health centre). The best validity parameters of the POUNDing rule were its positive predictive values: 90.9% (95% CI: 57.1-99.5%), 100% (95% CI: 73.2-99.3%), and 96.0% (95% CI: 77.7-99.8%) in the patients of the neurology clinic, the health centre and in the total population, respectively, and its low negative predictive values: 6.8% (95% CI: 2.2-17.3%), 3.1% (95% CI: 0.2-18.0%), and 5.5% (95% CI: 2.0-12.9%), also respectively in the patients of the neurology clinic, the health centre and in the total population. CONCLUSIONS: The POUNDing mnemonic rule has a high positive predictive values and can be a great help in accepting or rejecting a diagnosis of migraine, facilitating a more efficient use of neuroimaging tests


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Transtornos de Enxaqueca/diagnóstico por imagem , Valor Preditivo dos Testes , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X
17.
PM R ; 11(1): 90-93, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29933094

RESUMO

This case describes a 16-year-old boy who suffered a severe traumatic brain injury. The patient gradually recovered but developed debilitating spasticity mainly in left triceps muscle, abnormal positioning of shoulder girdle complex, and shoulder pain. Phenol (6%) was injected to axillary and radial nerves under the guidance of electrical stimulation and ultrasound imaging at 10 weeks after the initial injury. After injection, triceps spasticity and shoulder pain were immediately reduced, and abnormal positions of shoulder girdle complex and elbow joint gradually returned to functional limits over 2 weeks. This case suggests that phenol neurolysis for spasticity management in early recovery could yield functional recovery.Level of Evidence: V.


Assuntos
Lesões Encefálicas Traumáticas/complicações , Bursite/tratamento farmacológico , Espasticidade Muscular/tratamento farmacológico , Bloqueio Nervoso/métodos , Fenol/administração & dosagem , Acidentes de Trânsito , Adolescente , Lesões Encefálicas Traumáticas/diagnóstico , Lesões Encefálicas Traumáticas/terapia , Bursite/etiologia , Estimulação Elétrica/métodos , Escala de Coma de Glasgow , Humanos , Escala de Gravidade do Ferimento , Masculino , Espasticidade Muscular/fisiopatologia , Medição da Dor , Amplitude de Movimento Articular/efeitos dos fármacos , Recuperação de Função Fisiológica , Medição de Risco , Resultado do Tratamento
18.
Semergen ; 45(4): 232-238, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-30529010

RESUMO

INTRODUCTION: In assessing the patient with headache, clinicians are often faced with 2 important questions: Is this headache a migraine? Does this patient require neuroimaging? The aim of this study was to assess the validity and applicability of the mnemonic POUNDing rule in patients diagnosed with migraine. PATIENTS AND METHODS: A descriptive, validation study of the POUNDing rule in patients with a diagnosis of migraines and with a brain imaging test (computed tomography or magnetic resonance imaging), in an urban health centre and a neurology clinic of the University Hospital of Badajoz. RESULTS: A total of 116 patients were included (mean age 45.6 years; 79.3% women, 70 from the neurology clinics, and 46 from the health centre). The best validity parameters of the POUNDing rule were its positive predictive values: 90.9% (95% CI: 57.1-99.5%), 100% (95% CI: 73.2-99.3%), and 96.0% (95% CI: 77.7-99.8%) in the patients of the neurology clinic, the health centre and in the total population, respectively, and its low negative predictive values: 6.8% (95% CI: 2.2-17.3%), 3.1% (95% CI: 0.2-18.0%), and 5.5% (95% CI: 2.0-12.9%), also respectively in the patients of the neurology clinic, the health centre and in the total population. CONCLUSIONS: The POUNDing mnemonic rule has a high positive predictive values and can be a great help in accepting or rejecting a diagnosis of migraine, facilitating a more efficient use of neuroimaging tests.


Assuntos
Imageamento por Ressonância Magnética , Transtornos de Enxaqueca/diagnóstico , Tomografia Computadorizada por Raios X , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes
19.
Rev Int Androl ; 16(3): 95-101, 2018.
Artigo em Espanhol | MEDLINE | ID: mdl-30300136

RESUMO

OBJECTIVE: To assess the quality of sexual life reported by spinal cord-injured men treated with oral drugs for erectile dysfunction (ED) and their female partners. MATERIAL AND METHOD: Men with spinal cord injuries (SCI) complaining of ED and their female partners were evaluated using the Sexual Life Quality Questionnaire (SLQQ), a fully validated instrument in Spain. Two studies were conducted. A transversal study (1) on patients who were already on treatment with phosphodiesterase type 5 inhibitors (PDE5Is) and their partners, with 73 couples providing valid data. An additional prospective study (2) assessed SCI patients naive to PDE5Is in which both the patients and their spouses answered the SLQQ before treatment and after 3 months taking PDE5Is regularly, with 12 couples completing the study. RESULTS: The SLQQ scores of SC injured men on PDE5Is (study 1) were under the remembered pre-lesion level, with lower scores reported by those with complete lesions (P<.2 vs incomplete). Their partners' SLQQ scores were apparently similar to pre-injury times. The SLQQ scores of the patients and their partners were well correlated (r = 0.57, P<.0001), and they both reported high treatment satisfaction. Study 2: Untreated SCI patients reported very low SLQQ scores that were improved by PDE5Is treatment (P<.004), albeit without reaching the pre-injury level. A similar trend was found in their partners. Again both patients and partners reported high treatment satisfaction scores (P <.001). CONCLUSION: The sexual life quality levels of SC injured men on PDE5Is and their able-bodied spouses are well correlated. Both partners report high treatment satisfaction scores.


Assuntos
Disfunção Erétil/etiologia , Inibidores da Fosfodiesterase 5/administração & dosagem , Qualidade de Vida , Traumatismos da Medula Espinal/complicações , Adulto , Estudos Transversais , Disfunção Erétil/tratamento farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Estudos Prospectivos , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologia , Inquéritos e Questionários
20.
Rev. int. androl. (Internet) ; 16(3): 95-101, jul.-sept. 2018. graf
Artigo em Espanhol | IBECS | ID: ibc-178034

RESUMO

Objetivo: Evaluar la calidad de vida sexual de los varones con lesión medular (LM) con tratamiento farmacológico para la disfunción eréctil (DE) y de sus compañeras. Material y método: Se evaluó a varones de 18 a 65 años con LM y pareja estable que estuviesen en tratamiento de su DE mediante fármacos inhibidores de la fosfodiesterasa tipo 5 (iFDE5) o solicitasen iniciarlo. Se realizaron 2 estudios: un estudio transversal, sobre pacientes ya en tratamiento para la DE y sus compañeras, para el que 78 parejas proporcionaron datos válidos. Se complementó con un estudio prospectivo, sobre pacientes que iniciaban tratamiento para la DE y sus compañeras, comparando sus repuestas antes y a los 3 meses de iniciar el tratamiento; completaron este estudio 12 de las parejas invitadas. Los pacientes y sus parejas respondieron separadamente al Cuestionario de Calidad de Vida Sexual (SLQQ), validado en España. Resultados: Estudio transversal: las puntuaciones de la Escala de Calidad de Vida Sexual (parte I del cuestionario SLQQ) de los lesionados medulares en tratamiento fue inferior a la recordada con anterioridad a la lesión; por el contrario, para sus compañeras era similar a la prelesional. Las puntuaciones de ambos miembros de la pareja mostraron una robusta correlación (r = 0,57, p < 0,0001). Las puntuaciones de los pacientes con lesiones completas fueron inferiores a las lesiones incompletas (p < 0,02). Respecto a la satisfacción con el tratamiento (parte II del cuestionario SLQQ), las puntuaciones de los pacientes y sus compañeras estaban próximas al valor máximo de la escala y la prueba de Wilcoxon con respecto al valor de referencia fue muy significativa en ambos (p < 0,0001). Estudio prospectivo: los lesionados medulares mostraron bajas puntuaciones antes del tratamiento, que aumentaron significativamente a los 3 meses del tratamiento (p < 0,004). Las puntuaciones de satisfacción con el tratamiento fueron altas en ambos miembros de la pareja (p < 0,001). Conclusión: Los niveles de calidad de vida sexual informados por los pacientes con LM tratados con iFDE5 y sus compañeras sanas se muestran correlacionados. Ambos miembros de la pareja informaron de buena satisfacción con el tratamiento


Objective: To assess the quality of sexual life reported by spinal cord-injured men treated with oral drugs for erectile dysfunction (ED) and their female partners. Material and method: Men with spinal cord injuries (SCI) complaining of ED and their female partners were evaluated using the Sexual Life Quality Questionnaire (SLQQ), a fully validated instrument in Spain. Two studies were conducted. A transversal study (1) on patients who were already on treatment with phosphodiesterase type 5 inhibitors (PDE5Is) and their partners, with 73 couples providing valid data. An additional prospective study (2) assessed SCI patients naive to PDE5Is in which both the patients and their spouses answered the SLQQ before treatment and after 3 months taking PDE5Is regularly, with 12 couples completing the study. Results: The SLQQ scores of SC injured men on PDE5Is (study 1) were under the remembered pre-lesion level, with lower scores reported by those with complete lesions (P<.2 vs incomplete). Their partners' SLQQ scores were apparently similar to pre-injury times. The SLQQ scores of the patients and their partners were well correlated (r = 0.57, P<.0001), and they both reported high treatment satisfaction. Study 2: Untreated SCI patients reported very low SLQQ scores that were improved by PDE5Is treatment (P<.004), albeit without reaching the pre-injury level. A similar trend was found in their partners. Again both patients and partners reported high treatment satisfaction scores (P <.001). Conclusion: The sexual life quality levels of SC injured men on PDE5Is and their able-bodied spouses are well correlated. Both partners report high treatment satisfaction scores


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Traumatismos da Medula Espinal/complicações , Disfunção Erétil/tratamento farmacológico , Sexualidade/fisiologia , Inibidores da Fosfodiesterase 5/administração & dosagem , Qualidade de Vida , Parceiros Sexuais/psicologia , Resultado do Tratamento , Estudos Transversais , Satisfação do Paciente
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