RESUMO
Spasticity is a motor disorder with an increased muscle tone, typically associated with spasms, weakness and lack of coordination. It is an invalidating and debilitating pathology, characterized by pain, limited autonomy in activities of daily living, development of severe lesions. Spasticity can be adequately treated with physiotherapy, muscle relaxants drugs or topical treatment with botulinic toxin type A. Intrathecal baclofen therapy is very effective in the treatment of severe and generalized spasticity. Sometimes, soft tissues adjacent to the implant intrathecal infusion become infected; removing intrathecal infusion and systemic antibiotic therapy are best solution for clinical cure. However, removing intrathecal baclofen therapy could increase muscle spasticity with enhancement of pain and clonus that can worsen quality of life. In this study, we evaluated clinical improvement after complete healing of the septic focus and implantation of a new infuser.
Assuntos
Baclofeno/administração & dosagem , Infecções Relacionadas a Cateter/complicações , Agonistas dos Receptores de GABA-B/administração & dosagem , Bombas de Infusão Implantáveis/efeitos adversos , Infusão Espinal/efeitos adversos , Quadriplegia/tratamento farmacológico , Sepse/complicações , Abdome , Administração Oral , Adolescente , Antibacterianos/uso terapêutico , Baclofeno/uso terapêutico , Infecções Relacionadas a Cateter/tratamento farmacológico , Infecções Relacionadas a Cateter/microbiologia , Remoção de Dispositivo , Relação Dose-Resposta a Droga , Monitoramento de Medicamentos , Agonistas dos Receptores de GABA-B/uso terapêutico , Humanos , Bombas de Infusão , Deficiência Intelectual/complicações , Masculino , Quadriplegia/complicações , Quadriplegia/fisiopatologia , Reoperação , Sepse/tratamento farmacológico , Sepse/microbiologia , Índice de Gravidade de Doença , Infecções dos Tecidos Moles/complicações , Infecções dos Tecidos Moles/tratamento farmacológico , Infecções dos Tecidos Moles/microbiologia , Resultado do TratamentoRESUMO
Fibromyalgia (FM), clinical condition characterized by several signs and symptoms such as widespread pain, trigger point, morning stiffness and extreme tiredness for scarce hours of sleep, is linked to several changes in several brain neurotransmitters, particularly serotonin and norepinephrine. Consequently, the Neural Vegetative System works more and so it generates an exaggerated muscular contraction, sweating and constriction of blood vessels. The aim of our study was to treat a selected group of female patients suffering from FM with duloxetine with physiotherapy. We used two clinical scales (VAS and FIQ) and an objective evaluation such as myometric. The analysis of the data Myoton used during any inspection showed a statistically significant reduction in the values of muscle tone in each district analyzed. This finding was also confirmed by the patients themselves who have experienced a significant welfare and less muscle tension in different locations, as evidenced by data obtained from the clinical scales used by us. In addition, our patients were thought to be satisfied with the improvements not only subjective, but also with the objective witnessed myometry, making them a share of the study and feeling constantly monitored for treatment aimed at a real reduction in muscle stiffness. In conclusion, our study demonstrates combined treatment duloxetine- physiotherapy effectively reduces a symptom often disabling and particularly troublesome in patients with FM as the exaggerated muscle contraction.
Assuntos
Cloridrato de Duloxetina/uso terapêutico , Terapia por Exercício/métodos , Fibromialgia/diagnóstico , Fibromialgia/terapia , Músculo Esquelético/fisiologia , Reologia/métodos , Adulto , Analgésicos/uso terapêutico , Feminino , Fibromialgia/fisiopatologia , Humanos , Pessoa de Meia-Idade , Músculo Esquelético/efeitos dos fármacos , Inquéritos e Questionários , Resultado do TratamentoRESUMO
The present two studies extended research evidence on the use of microswitch technology by post-coma persons with multiple disabilities. Specifically, Study I examined whether three adults with a diagnosis of minimally conscious state and multiple disabilities could use microswitches as tools to access brief, selected stimulus events. Study II assessed whether an adult, who had emerged from a minimally conscious state but was affected by multiple disabilities, could manage the use of a radio device via a microswitch-aided program. Results showed that the participants of Study I had a significant increase of microswitch responding during the intervention phases. The participant of Study II learned to change radio stations and seemed to spend different amounts of session time on the different stations available (suggesting preferences among the programs characterizing them). The importance of microswitch technology for assisting post-coma persons with multiple disabilities to positively engage with their environment was discussed.
Assuntos
Coma/reabilitação , Auxiliares de Comunicação para Pessoas com Deficiência , Pessoas com Deficiência/reabilitação , Estado Vegetativo Persistente/reabilitação , Rádio , Tecnologia Assistiva , Idoso , Coma/fisiopatologia , Pálpebras , Feminino , Dedos , Humanos , Masculino , Pessoa de Meia-Idade , Movimento , Estado Vegetativo Persistente/fisiopatologiaRESUMO
The aim of the study was to evaluate the effects of transcutaneous electric nerve stimulation (TENS) on CO(2) laser evoked potentials (LEPs) in 16 normal subjects. The volar side of the forearm was stimulated by 10 Hz TENS in eight subjects and by 100 Hz TENS in the remainder; the skin of the forearm was stimulated by CO(2) laser and the LEPs were recorded in basal conditions and soon after and 15 min after TENS. Both low and high frequency TENS significantly reduced the subjective rating of heat stimuli and the LEPs amplitude, although high frequency TENS appeared more efficacious. TENS seemed to exert a mild inhibition of the perception and processing of pain induced by laser Adelta fibres activation; the implications of these effects in the clinical employment of TENS remain to be clarified.