RESUMEN
Headaches are a frequent health problem among children and adolescents. The ocurrence of headaches and the resulting impairments in the quality of life and activities of daily living are modulated by biopsychosocial interactions, which necessitate a complex treatment program. The Dresden Childrens Headache Program (DreKiP) is a multidisciplinary therapy program consisting of eight modules for children and adolescents: education, stress relief, relaxation techniques, physical fitness, climbing therapy, art therapy and sensory training. In addition, there are six modules containing parallel workshops for parents. This outpatient program lasts 2-3 months and is performed parallel to the daily and school routine. Therapy groups consist of 6-8 patients in each age group. In total patients receive 15 h and the parents 7 h of therapy. Concomitant with the program, headache-associated data, such as headache frequency, medication use and school absence are documented. So far 32 children and adolescents in groups of 11, 14-15, 14-16, 17 and 17-18 years old completed the program. Of the 32 patients 19 presented with migraine and tension type headache, 6/32 with migraine and 7/32 with tension type headache only. The median number of headache days was 15 per month and 4 official school absence days per month. Preliminary results 6 months after the end of the therapy program showed reduced frequency of headaches in three quarters of our patients. The headache frequency was reduced from an initial median of 15 days per month to a median of 8 days per month after the program. The multidisciplinary program DreKiP improves the use of therapeutic means in children and adolescents with primary headaches. Children and adolescents with headache-related impairment in activities of daily life in school and leisure times constitute the target group of this therapy.
Asunto(s)
Trastornos Migrañosos , Actividades Cotidianas , Adolescente , Niño , Cefalea/terapia , Humanos , Pacientes Ambulatorios , Calidad de VidaRESUMEN
A major hindrance to the use of PBSC in allogeneic transplantation is the high rate of contamination with T lymphocytes, resulting in a considerable risk of GvHD. Natural killer (NK) cells are active against tumor cells but do not contribute to the development of GvHD. After adsorption of CD34+ cells of mobilized allogeneic leukapheresis products on a Ceprate column, we studied the separation of CD34 unadsorbed cells by counterflow centrifugal elutriation (CCE). Up to 1.0 x 10(10) cells were clearly separated into lymphocytes (fractions 110 and 140 ml/min), monocytes, and polymorphonuclear cells (fraction rotor off). Characterized by flow cytometry, T cells were distributed nearly equal to fractions 110 and 140. NK cells were concentrated 3.4-fold in fraction 140 as compared with the unseparated cells. The ratio of NK cells/T cells was improved by 33%. These results indicate that CCE is an effective method to enrich NK cells and to reduce T cells in stem cell separation products. Therefore, it is an option for adoptive therapy of cancer patients after transplantations (e.g., CML in relapse).