Effectiveness of short-term physical agents treatment on macroscopic morphology in patients with plaque psoriasis / Efectividad del tratamiento a corto plazo de los agentes físicos en la morfología macroscópica de las placas de psoriasis

Psoriasis is a chronic inflammatory disease that presents skin rashes which can arise through plaques. The aim of this work was to compare the effectiveness of short-term physical agents treatment on macroscopic morphology (area and erythema) in patients with plaque psoriasis. This prospective randomized experimental study included fourteen subjects, medically diagnosed with psoriasis, with more than one plaque in the skin and voluntarily without topical treatment. All subjects completed the study that consisted of 12 treatment sessions divided in control (C), artificial balneotherapy (AB), phototherapy (PT) or balneophototherapy (BPT) groups. After session 12, there was a significant reduction of the plaque area by all treatments when compared to C group and BPT was the most effective one. However, only AB and PT presented a reduction of erythema. Regarding severity, 9 patients changed to a lower category on the PASI test, and 5 of them maintained a mild psoriasis, but lowered their score. Finally, 13 of 14 subjects improved their quality of life. The physical agents used reduced the severity of psoriasis and improved quality of life of patients after 12 sessions of treatment during a onemonth period. The BPT was the more effective in controlling psoriasis by diminishing its area and PT by attenuating the erythema.

La Psoriasis es una enfermedad inflamatoria crónica que presenta irritación cutánea que puede derivar a placas. El objetivo de este trabajo fue comparar la efectividad del tratamiento a corto plazo con agentes físicos en la morfología macroscópica (área y eritema) en pacientes con placas de psoriasis. Estudio experimental, prospectivo, randomizado. Catorce sujetos participaron con diagnóstico médico de psoriasis, con más de una placa en la piel y sin tener tratamiento tópico de forma voluntaria. Todos los sujetos completaron el estudio, el cual consistió de 12 sesiones de tratamiento dividido en grupo control (C), BA, FT y BFA. Posterior a la sesión 12, se observó una reducción significativa en toda el área de las placas que recibieron tratamiento al compararlas al grupo C y el grupo BFA fue el más efectivo. Sin embargo, solo los grupos BA y FT presentaron una reducción del eritema. Respecto a la severidad, 9 pacientes cambiaron de la baja categoría en el test de PASI y 5 de ellos se mantuvieron en el nivel medio, pero disminuyeron su puntaje. Finalmente, 13 de 14 sujetos mejoraron su calidad de vida. Los agentes físicos usados redujeron la severidad de la psoriasis y mejoraron la calidad de vida de los pacientes después de 12 sesiones de tratamiento durante el período de un mes. La BFA fue la más efectiva en controlar la psoriasis por la disminución en el área y la FT por la atenuación del eritema.

Efecto terapéutico de las aguas mineromedicinales en el tratamiento de la gingivoestomatitis herpética aguda / Therapeutic effect of medicinal mineral needles in the treatment of acute herpetic gingivostomatitis

Introducción: el empleo de las aguas con fines curativos, se remonta a épocas tempranas en la evolución del hombre. Objetivo: determinar el efecto terapéutico de aguas mineromedicinales en el tratamiento de gingivoestomatitis herpética aguda. Métodos: estudio analítico cuasiexperimental, en el Policlínico Gilberto Marquetty, Candelaria, Artemisa, en el periodo de octubre de 2011 a octubre de 2012, con un universo de 110 niños de 1 a 14 años diagnosticados con gingivoestomatítis herpética aguda. Por muestreo aleatorio simple se dividieron en dos grupos, Grupo 1 (Control) 55 pacientes, se aplicó tratamiento convencional con antihistamínico y analgésicos, prescripto por el facultativo. Grupo 2 (Estudio): 55 pacientes, se aplicó tratamiento con aguas mineromedicinales. Las variables estudiadas fueron edad, sexo, zona de residencia, síntomas colaterales, zonas anatómicas afectadas y evolución. Se consideró favorable cuando curó o mejoró y desfavorable cuando siguió igual o empeoró. La información se obtuvo por examen físico evolutivo al tercer, quinto y décimo día de tratamiento, evaluando sintomatología y cuadro clínico. Para el análisis de la información se utilizó distribución de frecuencias absolutas y porcentaje. Resultados: evolución satisfactoria, en menos días de tratamiento y con ausencia de reacciones adversas en los pacientes tratados con aguas mineromedicinales; el 50,90 por ciento de niños al tercer día de tratamiento estaban curados y el 96,36 por ciento, al décimo día. Conclusiones: las aguas mineromedicinales del manantial El Templado de San Diego de los Baños tiene efectos terapéuticos favorables en el tratamiento de las gingivoestomatitis herpética aguda en niños; se logró una evolución clínica favorable en menor tiempo que en el tratamiento convencional(AU)

Introduction: The use of needles with therapeutic aims dates back to early ages in humankind evolution. Objective: To determine the therapeutic effect of medicinal mineral needles in the treatment of acute herpetic gingivostomatitis. Methods: Quasi-experimental analytical study, in Gilberto Marquetty Polyclinic of Candelaria, Artemisa Province, from October 2011 to October 2012, with a target group of 110 children at ages 1-14 years diagnosed with acute herpetic gingivostomatitis. By random sampling, they were divided into two groups: 1 (control group, 55 patients), to which conventional treatment with antihistaminic and analgesics, prescribed by the doctor; 2 (study group, 55 patients), to which treatment was applied with medicinal mineral needles. The variables studied were age, sex, dwelling area, side symptoms, affected anatomical areas and natural history. It was considered favorable when healed or ameliorated; and unfavorable when remained the same or worsened. The information was obtained by followed-up physical examination after three, four and five days of treatment, evaluating symptoms and clinical frame. For information analysis, distribution of absolute frequencies and percentages were used. Results: Satisfactory natural history, in less than ten days of treatment and without side effects in patients treated with medicinal mineral needles. 50.90 percent of children were healed after three days of treatment and 96.36 percent after ten days. Conclusions: medicinal mineral needles from El Templado springs of San Diego de los Baños have favorable therapeutic effects in the treatment of acute herpetic gingivostomatitis in less time than the conventional treatments(AU)

Balneotherapy is a potential risk factor for Pseudomonas aeruginosa colonization

ABSTRACT The practice of immersion in burn patient has been abandoned in many parts of the world but in Brazil it is still common. The aim of this study was to ascertain if balneotherapy is a risk factor for Pseudomonas aeruginosa colonization in thermally injured patients. Eighteen patients from a Burn Center were studied for 14 weeks for Pseudomonas aeruginosa. Samples were collected by swabbing the exudate of wounds, before and after giving bath to the patients and from balneotherapy table. Pulsed-field gel electrophoresis was used to determine bacterial genetic relatedness. Thirty-seven P. aeruginosa isolates were detected from 292 swabs collected from patients' burn surface area and from the balneotherapy table. Profile analysis of P. aeruginosa DNA fragmentation showed 10 clones among the 37 strains analyzed. Type A is the most prevalent clone, with 23 strains distributed into eight subtypes. These were present in the swabs collected, before and after the patients' bath, from the surface of the bath table, suggesting that there was cross-contamination between the patients in different ways. This work demonstrates that balneotherapy is a risk factor in the Burn Center studied, because the same clone was found among P. aeruginosa isolates collected at various points and times.

RESUMO A prática de balneotarapia em paciente queimado foi abandonada em muitas partes do mundo, mas no Brasil ainda é comum. O objetivo deste estudo foi verificar se a balneoterapia é um fator de risco para a colonização por Pseudomonas aeruginosa em pacientes queimados. Dezoito pacientes internados em um Centro de Queimadura (CQ) foram acompanhados por 14 semanas. Amostras foram coletadas do exsudato de feridas, antes e depois do banho dos pacientes e também da mesa onde a balneoterapia foi realizada. A relação genética entre as cepas de P. aeruginosa foi determinada pela electroforese em gel de campo pulsado. Trinta e sete cepas foram detectadas a partir de 292 swabs coletados de área de superfície das feridas dos pacientes e da mesa de balneoterapia. Análise de fragmentação do DNA das 37 P. aeruginosa mostrou a existência de 10 clones. O tipo A foi o clone mais prevalente, com 23 cepas distribuídas em oito subtipos. Estas estavam presentes nas lesões dos pacientes antes e após o banho e na mesa onde o banho foi realizado, sugerindo contaminação cruzada inter e intra-pacientes e pacientes e mesa de banho. Este trabalho mostra que a balneoterapia é um fator de risco para colonização por P. aeruginosa, no CQ estudado, pois um mesmo clone da bactéria foi encontrado nos isolados coletados em vários pontos e épocas diferentes.

Passive body heating improves sleep patterns in female patients with fibromyalgia

OBJECTIVE: To assess the effect of passive body heating on the sleep patterns of patients with fibromyalgia. METHODS: Six menopausal women diagnosed with fibromyalgia according to the criteria determined by the American College of Rheumatology were included. All women underwent passive immersion in a warm bath at a temperature of 36 ±1 °C for 15 sessions of 30 minutes each over a period of three weeks. Their sleep patterns were assessed by polysomnography at the following time-points: pre-intervention (baseline), the first day of the intervention (acute), the last day of the intervention (chronic), and three weeks after the end of the intervention (follow-up). Core body temperature was evaluated by a thermistor pill during the baseline, acute, chronic, and follow-up periods. The impact of this treatment on fibromyalgia was assessed via a specific questionnaire termed the Fibromyalgia Impact Questionnaire. RESULTS: Sleep latency, rapid eye movement sleep latency and slow wave sleep were significantly reduced in the chronic and acute conditions compared with baseline. Sleep efficiency was significantly increased during the chronic condition, and the awakening index was reduced at the chronic and follow-up time points relative to the baseline values. No significant differences were observed in total sleep time, time in sleep stages 1 or 2 or rapid eye movement sleep percentage. The core body temperature and Fibromyalgia Impact Questionnaire responses did not significantly change over the course of the study. CONCLUSION: Passive body heating had a positive effect on the sleep patterns of women with fibromyalgia.

Quality of Life of Psoriasis Patients before and after Balneo - or Balneophototherapy

PURPOSE: An observational prospective study was conducted to study the effects of hypotonic spa-water baths and narrowband ultraviolet B therapy given alone or in combination for treatment of moderate-severe psoriasis. MATERIALS AND METHODS: Two treatments were analysed: 2 weeks of balneotherapy followed by ultraviolet-B (UVB) 311-nm phototherapy (BPT) or 2 weeks of daily bath treatments of Comano water alone (BT). One hundred and eleven adult patients with moderate to severe chronic plaque psoriasis were enrolled. Quality of life (QoL) questionnaires {36-item Short Form of the Medical Outcomes Study questionnaire (SF-36) and Skindex-29} were administered at baseline and 2 months from the end of therapy. The self-administered Psoriasis Area Severity Index (SAPASI), and the General Health Questionnaire (GHQ)-12 (to assess clinical severity and psychological distress, respectively) were also recorded at the same time-periods. RESULTS: SAPASI was significantly reduced from 15.2 to 8.7 in BPT group and 11.6 to 7.8 in BT. A decrease of greater than 50% after therapy in SAPASI_50 score was reached by 42% and 37% of patients in the BPT and BT groups, respectively. At follow-up, both groups had better scores on all SF-36 scales (with statistically significant improvement in social functioning and mental health in the BPT group) and in all Skindex-29 scales. A statistically significant reduction of GHQ-12 positive cases was observed in the BPT group. CONCLUSION: Comano spa-water alone or in combination with phototherapy had beneficial therapeutic effects on patients with psoriasis. Although our observational study design prevents us from making meaningful comparisons between the 2 interventions, the combination of balneo and phototherapy seems to improve QoL and lessen clinical severity, and reduced the proportion of GHQ-12 positive cases.

Efectividad del tratamiento termal en pacientes con gonoartrosis. Atención de enfermería / Effectiveness of the thermal treatment in patients with gonoarthosis. Nursing care

La balneología es una de las ramas más antiguas de la medicina, la cual fue desarrollada por los romanos durante milenios, para lo cual crearon las bases científicas de estos tratamientos. Se realizó una investigación retrospectiva y longitudinal en 30 pacientes con gonoartrosis en el Balneario de San Diego de los Baños, con el objetivo de demostrar la efectividad del tratamiento y relacionar la atención de enfermería; a dichos pacientes se les entrevistó y revisaron sus historias clínicas, recogiendo las siguientes variables: edad sexo, signos y síntomas, uso de rodillera y bastón, tratamiento y efectivad de éstos, datos tabulados por el método de palotes para su mejor comprensión, y se concluyó que en la mayoría de los pacientes predominó el dolor y la limitación articular, así como la efectividad del tratamiento termal complementado con tratamiento fisioterapéutico, y que es significativa la atención de enfermería en estos pacientes(AU)

Balneology is one of the most ancient medicine branches which was developed by the Romans for millennia and for which they created the scientific basis of these treatments. A retrospective longitudinal study was made on 30 patients with gonoarthrosis in San Diego de los Baños spa, with the aim of showing the effectiveness of the treatment and the nursing care. These patients were interviewed and their medical histories were reviewed taking into account the following variables: age, sex, signs and symptoms, use of knee guard and walking stick, kinds of treatments and effectiveness, etc. Data were tabulated by the downstroke method (método de palotes) for a better understanding. It was concluded that pain and joint restriction predominated in most patients, thermal treatment supplemented with physiotherapy was effective and that care given by nurses to these patients was significant(AU)