Dolor lumbar somático tratado con terapia neural y ozono paravertebral / Somatic low back pain treated with neural therapy and paravertebral ozone

La presente investigación tuvo como objetivo general evaluar el efecto de la terapia neural e infiltración paravertebral segmentaria con ozono en el dolor lumbar somático de los pacientes que asistieron a la consulta de terapia del dolor en el Hospital Dr. Pedro García Clara, Ciudad Ojeda Estado Zulia-Venezuela, en el periodo comprendido del 01 de abril al 31 de mayo del 2016. Fue un estudio prospectivo, explicativo-comparativo y el diseño fue cuasi-experimental. Se seleccionaron 60 pacientes de ambos sexos entre edades comprendidas de 18 a 60 años, se dividieron en dos grupos de 30 pacientes, al primer grupo denominado A, se le realizó terapia neural segmentaria lumbar utilizando procaína al 1% y consecutivamente se le aplicó infiltración paravertebral con ozono a una concentración de 15ug; y al grupo B, se le realizó terapia neural con lidocaína al 1% y posteriormente se le aplicó la infiltración paravertebral con ozono a una concentración de 15ug, ambos grupos con un volumen de 10mL. Para el análisis de los datos se utilizó estadística descriptiva e inferencial, específicamente la prueba t de Student para las muestras relacionadas. Resultados: indicaron que en ambas terapias, al evaluar el dolor con la escala visual análoga, se encontraron diferencias estadísticamente significativas (p<0,05), en ambos grupos. Conclusiones: no hubo diferencias estadísticamente significativas con respecto a los cambios hemodinámicos y la disminución del dolor fue significativa en ambos grupos, pero más notable en el grupo A(AU)

The present study was aimed at evaluating the overall effect of neural therapy and segmental paravertebral ozone infiltration in lumbar somatic pain patients attending the consultation of pain therapy Dr. Pedro Garcia Clara Hospital of Ciudad Ojeda Estado Zulia-Venezuela, in the period from 01 April to 31 May 2016. It was a comparative-explanatory, prospective study design was quasi-experimental, 60 patients of either sex between aged from 18 to 60 years were selected, they were divided into two groups of 30 patients, the first group called A, underwent neural therapy lumbar segmental using procaine 1% and consecutively was applied paravertebral infiltration with ozone at a concentration of 15ug; and group B, underwent neural therapy with lidocaine 1% and was subsequently applied the paravertebral infiltration with ozone at a concentration of 15ug, both groups with a volume of 10mL. For data analysis the mean, standard deviation, and inferential statistics, specifically the Student t test for related samples was used. Results: indicated that both therapies, to assess pain with visual analogue scale, statistically significant differences (p<0.05) in both groups. Conclusions: There were no statistically significant differences with respect to hemodynamic changes and pain reduction was significant in both groups, but more remarkable in group A(AU)

Lower weight gain with the orally disintegrating olanzapine than with standard tablets in first-episode never treated psychotic patients.

OBJECTIVE: A post-hoc analysis of the data from a randomised clinical trial involving prescription of antipsychotic treatment to never treated first-onset psychotic patients was used to compare the weight change after 6-week olanzapine treatment (standard tablets vs. orally disintegrating formulation). METHOD: In the subgroup of 38 patients randomised to olanzapine, standard olanzapine tablets were non-randomly and consecutively prescribed to the first 19 patients, with the orally disintegrating formulation being prescribed to the following 19 patients. RESULTS: After 6-week treatment with olanzapine, a significant higher increase in weight was noted in those patients on standard tablets (mean weight increase 6.3 +/- 1.9 Kg) as compared to those on orally disintegrating olanzapine (mean weight increase 3.3 +/- 3.2 Kg) (F = 7.7; p = 0.009). BMI increase was also significantly higher in the olanzapine tablet group (mean increase of 2.1 Kg/m(2) as compared with 1.1 Kg/m(2) in the orally disintegrating group) (F = 4.7; p = 0.036). Substantial weight gain (SWG) (> or =7% increase from baseline weight) was noted in 84.2% (n = 16) of the olanzapine tablet patients and in 31.6% (n = 6) of the orally disintegrating olanzapine patients, with the olanzapine tablet group showing a significant increase in the mean percentage of weight gain (F = 4.0; p = 0.014). CONCLUSIONS: Partial sublingual absorption occurring with orally disintegrating olanzapine may bypass gastrointestinal metabolisation and hence lead to differences in metabolite versus parent compound ratios. However, the need arises to replicate the present study with a longer follow-up.

Plasma methadone concentrations as an indicator of opioid withdrawal symptoms and heroin use in a methadone maintenance program.

Plasma methadone concentrations and its main metabolite D,L-2-ethylidiene-1,5-dimethyl-3,5-diphenylpyrrolidine (EDDP) were determined in 93 patients under methadone maintenance treatment to assess their relationship with heroin use and opioid withdrawal symptoms. Neither plasma concentrations of methadone nor EDDP were significantly different when patients that used heroin in last 3 months were compared with those testing negative for this drug (methadone, 355 +/- 217 versus 369 +/- 216 ng/ml, t = 0.29, P = NS; EDDP, 49 +/- 28 versus 54 +/- 40 ng/ml, t = 0.51, P = NS). No correlation between opioid withdrawal scale scores and plasma concentrations of methadone (r = 0.02, P = NS) and EDDP (r = -0.14, P = NS) was found. Therapeutic drug monitoring during methadone maintenance seems to be useful for assessing compliance with treatment but not for predicting heroin use and subjective withdrawal symptoms.

Immature endodermal teratoma of the ovary: embryologic correlations and immunohistochemistry.

Two grade 2 ovarian immature, predominantly endodermal teratomas are reported. The teratomas were in stage I and occurred in two girls, 9 and 10 years of age, who were treated with triple chemotherapy. These neoplasms differed from the usual immature ovarian teratoma as they contained no neuroectodermal components and had high alpha-fetoprotein and low human chorionic gonadotropin levels as their serum markers despite the absence of other concomitant germ cell tumors. The epithelia of the teratomas demonstrated exclusively the embryologic development of endoderm, ranging from early endoderm to tissues similar to esophagus, liver, and intestinal structures. All epithelial derivatives were positive for alpha-fetoprotein and alpha 1-antitrypsin. Liver and esophagus expressed fibrinogen, while intestine and esophagus were positive not only for carcinoembryonic antigen and chromogranins but also for thyroglobulin, thus reflecting yet another type of endodermal differentiation into thyroid. Focal human chorionic gonadotropin positivity associated with primitive intestinal and esophageal epithelia may reflect the early embryologic relationships between endoderm and trophoblast. These cases demonstrate that simultaneous alpha-fetoprotein and human chorionic gonadotropin secretion may occur in immature teratoma. The mesenchymal component also showed a wide range of differentiation, from primitive mesoblastic cells to differentiated cells, such as hemopoietic foci, smooth muscle, bone, and cartilage. Both the primitive endoderm and the mesenchyme co-expressed vimentin and keratin, reflecting their intimate developmental relationships and possibly supporting the hypothesis of mesenchyme originating from endoderm, as suggested by previous embryologic studies. Since endodermal and mesenchymal areas similar to those described here are found in association with yolk sac tumors and embryonal carcinoma, it is possible that the present cases may represent an endodermal differentiation accomplished by either of these developmentally related germ cell tumors.