Enuresis no orgánica tratada con medicamentos homeopáticos / Non-organic nocturnal enuresis treated with homeopathic drugs

RESUMEN Introducción: la enuresis nocturna en niños es motivo de consulta frecuente. Objetivo: evaluar la evolución clínica en pacientes pediátricos de cinco a 18 años, con enuresis nocturna no orgánica, tratados con medicamentos homeopáticos. Métodos: se realizó un estudio cuasi-experimental de intervención. La muestra se conformó de forma intencional por 327 pacientes con enuresis de la consulta de Homeopatía del Hospital Provincial Pediátrico Docente, "Pepe Portilla", de enero del 2015 a enero 2018. En el procesamiento se utilizaron herramientas descriptivas como tablas de frecuencias y cálculo porcentual. Además de la prueba Kolmogorov Smirnov para comparar tendencia de variables entre dos grupos independientes. Resultados: predominaron los niños entre cinco a 11 años del sexo masculino. En ambos grupos prevaleció la enuresis primaria, la incapacidad para despertar y los antecedentes familiares de enuresis. En el grupo estudio, 76,1 % tuvo respuesta completa al tratamiento, solo un caso no tuvo respuesta; en el grupo control solo 8,3 % de los pacientes obtuvo respuesta completa. Conclusiones: la Homeopatía es una modalidad terapéutica útil en el tratamiento de la enuresis no orgánica en niños.

ABSTRACT Introduction: nocturnal enuresis in children is a frequent reason for attending the doctor's office. Objective: to evaluate the clinical evolution in pediatric patients from 5 to 18 years old with non-organic nocturnal enuresis treated with homeopathic drugs. Methods: a quasi-experimental intervention study was conducted. The sample intentionally comprised 327 patients with nocturnal enuresis from the Homeopathy Clinic at Pepe Portilla Provincial Pediatric Teaching Hospital, from January 2015 to January 2018. Descriptive tools such as frequency tables and percentage calculation were applied to process the data. In addition to the Kolmogorov Smirnov test to compare the trend of the variables between two independent groups. Results: male children between 5 and 11 years old predominated. In both groups, primary enuresis, the characteristic inability to wake up and family history of enuresis prevailed. In the study group, 76.1% had complete response to treatment, only one case had no response, in the control group only 8.3% of patients had complete response. Conclusions: homeopathy is a useful therapeutic modality in the treatment of non-organic nocturnal enuresis in children.

Patient Journeys of Nonintegration in Hungary: A Qualitative Study of Possible Reasons for Considering Medical Modalities as Mutually Exclusive.

INTRODUCTION: Complementary and alternative medicine (CAM) use has been increasing in the past decades in tandem with changes regarding the notions of health and illness. Comparing conventional medicine (CM) and CAM in how they address health problems has been a point of focus for both the health sciences and individuals dealing with health problems. Various social, cultural, political, economic, and personal factors play a role in whether different health approaches are integrated or not when addressing illness experiences. METHODS: The qualitative study comprised semistructured interviews (N = 9) and participant observation involving 105 patients conducted between January 2015 and May 2017 at 4 clinics of Traditional Chinese Medicine in Budapest, Hungary. Code structures were created inductively with Interpretative Phenomenological Analysis. RESULTS: The mutually exclusive view of CM/CAM use occurred due to loss of trust in the doctor-patient relationship causing problems in communication, and also as a result of the patient espousing certain cultural dispositions. Significant dispositions included a preference for the "natural" and psychologization, the latter often manifested in psychosocial etiology, vitalism, and illness symbolism. DISCUSSION: A polarized choice of therapy may occur as a result of a competitive health care market in which medical modalities and their underlying cultural systems compete within a global milieu of information proliferation and a hybridization of individual worldviews. Through a process of "cultural creolization", changing concepts of health and illness create varying patient expectations and meanings regarding illness, which in turn affect therapy choice as well. CONCLUSION: Mirrored in the articulation of an individual's illness trajectory is a tension that is also reflected in the struggles in the health care system to more adequately understand health/illness processes from a pluralistic perspective. The power relations in the health arena (among CAM/CM practitioners and systems) play a role in legitimizing or undermining different health practices, which as consequence affects the possibility of integrating them into the processes of care. Thus, therapy choice is not only linked to changing notions of health and illness, but also to shifting conceptualizations of self, identity, and the practitioner-patient relationship.

Long-chain omega-3 polyunsaturated fatty acid dietary intake is positively associated with bone mineral density in normal and osteopenic Spanish women.

The regular consumption of long-chain omega-3 polyunsaturated fatty acids (LCO3-PUFAs) results in general health benefits. The intake of LCO3-PUFAs has been reported to contribute to bone metabolism. We aimed to investigate the relationships between dietary intakes of LCO3-PUFAs and bone mineral density (BMD) in Spanish women aged 20-79 years old. A total of 1865 female subjects (20-79 years old) were enrolled, and lumbar (L2, L3, L3 and total spine), hip (femoral neck (FN), femoral trochanter (FT) and Ward's triangle (WT)) bone mineral density (BMD) were measured by dual energy X-ray absorptiometry (DXA). Dietary intakes of total energy, calcium, vitamin D, alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and n-6 fatty acids (linoleic acid (LA) and arachidonic acid (AA)) were assessed by a self-administered food frequency questionnaire (FFQ). Spearman's rank correlations between LCO3-PUFAs and BMD were estimated. Partial correlations controlling for age, weight, height, dietary calcium, vitamin D, menopausal status and energy were calculated. A multiple regression analysis was computed to assess significant associations with BMD in this population. After adjustment for potential confounding factors, there were positive correlations between ALA, EPA and DHA intake and BMD. According to the WHO diagnosis criteria for osteoporosis, in this population of normal and osteopenic women, the dietary intake of ALA was also significantly associated with BMD at the hip. In normal women, the dietary intake of DHA was also significantly associated with BMD at the lumbar spine. No significant associations between LCO3-PUFAs and BMD were detected in the lumbar spine of osteopenic or osteoporotic women. The dietary intake of LCO3-PUFAs was positively associated with BMD in Spanish women at both the hips and the lumbar spine. We highlight that the intake of LCO3-PUFAs is not significantly associated with BMD in osteoporotic women; however, the intake of LCO3-PUFAs seems to be positively associated with BMD at both the hips and the lumbar spine in normal and osteopenic women.

The medial nucleus of the trapezoid body in rat: spectral and temporal properties vary with anatomical location of the units.

The medial nucleus of the trapezoid body (MNTB) is a distinct nucleus in the superior olivary complex that transforms excitatory input from the cochlear nucleus into a widespread inhibitory output to distinct auditory brainstem nuclei. Few studies have dealt with the response properties of MNTB neurons to sound stimulation using in vivo preparations. In order to have a better understanding of the functional significance of the MNTB in auditory processing we report the basic temporal and spectral response properties of its principal cells using single-unit extracellular recordings to acoustic stimulation with pure tones and amplitude-modulated stimuli in the rat. Ninety-seven per cent of units showed V-shaped frequency response areas. Rate level functions were mainly saturating (51%) or monotonic (45%) at high intensities. Post-stimulus time histograms typically were characterised as primary-like with notch (59%) or primary-like (33%). Units showed good phase-locking to sinusoidally amplitude-modulated signals with vector strength VS values up to 0.87. Modulation transfer functions had low-pass shapes at near-threshold levels, with cut-off frequencies ranging from 370 to 1270 Hz. Exploration of the relationship between the temporal and spectral properties and the location of the units in the MNTB yielded characteristic frequency (CF)-dependent response properties (latency, Q(10) and cut-off frequency) following a medio-lateral gradient, and CF-independent response features (maximum firing rate) following a dorso-ventral gradient.

A discontinuous tonotopic organization in the inferior colliculus of the rat.

Audible frequencies of sound are encoded in a continuous manner along the length of the cochlea, and frequency is transmitted to the brain as a representation of place on the basilar membrane. The resulting tonotopic map has been assumed to be a continuous smooth progression from low to high frequency throughout the central auditory system. Here, physiological and anatomical data show that best frequency is represented in a discontinuous manner in the inferior colliculus, the major auditory structure of the midbrain. Multiunit maps demonstrate a distinct stepwise organization in the order of best frequency progression. Furthermore, independent data from single neurons show that best frequencies at octave intervals of approximately one-third are more prevalent than others. These data suggest that, in the inferior colliculus, there is a defined space of tissue devoted to a given frequency, and input within this frequency band may be pooled for higher-level processing.

Twice- vs. thrice-weekly MPD PUVA in psoriasis: a randomized-controlled efficacy study.

BACKGROUND: Oral psoralen-ultraviolet A (PUVA) has been the treatment of choice of moderate to severe forms of psoriasis, however there is no standardized worldwide protocol. Twice- and thrice-weekly regimens had been used. In this study we compare the efficacy of these regimens. METHODS: Two PUVA regimens in 28 patients with clinical diagnosis of psoriasis, with symmetric and no less than 20% of body surface area involvement, using a half-body study, were compared. Each patient body half was randomized to receive either twice- or thrice-weekly PUVA. A blinded trained dermatologist assessed the PASI score in each body half at the beginning of the study and at clearance or after 25 sessions. RESULTS: Twenty-three patients completed the study. There were no significant differences in the efficacy of both treatments considering the median percentage of PASI decrease (92.9% for the body half with the twice-weekly regimen and 94.8% for the thrice-weekly treatment, P=0.179). There were significant differences comparing the median number of sessions needed for clearance and the median cumulative doses, favouring the twice-weekly regimen (15 vs. 22, P=0.000, and 142.5 vs. 241.4 J/cm(2), P=0.001, respectively). CONCLUSION: The treatment of psoriasis patients with twice- or thrice-weekly PUVA in this study was equally effective, the number of sessions required and the cumulative doses of UVA were lower with the twice-weekly regimen.

Clínica, diagnostico y tratamiento de las reacciones medicamentosas / Clinics, diagnosis and treatment of the drugs reactions

Las reacciones adversas a medicamentos ocupan un lugar importante en la consulta dermatológica, por esta razón se realizó una revisión de la literatura. La cual se divide en dos partes, en la primera se describe la fisiopatogenia de las reacciones adversas a medicamentos, desde los principios de la farmacocin,tica, clasificación de las mismas, descripción de las reacciones de hipersensibiblidad que se presentan, el comportamiento de los medicamentos que pueden actuar como potenciales compuestos antig,nicos, la correlación con entidades virales que puedan comportarse como como facilitadores de estas respuestas y los tipos de medicamentos que m s frecuentemente se asocian con este tipo de reacciones. La segunda parte describe las manifestaciones clínicas, los m,todos diagnósticos existentes de uso In vivo como In vitro y la aproximación al tratamiento de las reacciones a medicamentos. Con esta revisión se evidencia el amplio espectro clínico de las reacciones medicamentosas y la importancia de sospecharlas siempre para realizar un diagnóstico y por lo tanto un manejo adecuado de las mismas