Rehabilitación vestibular domiciliaria guiada asistida por medios audiovisuales / Guided home-based vestibular rehabilitation assisted by audiovisual media

Introducción: Presentamos un estudio prospectivo experimental para valorar el proceso de creación y validación de un modelo de soporte audiovisual para el diseño de programas de rehabilitación vestibular domiciliaria guiada (RVDG). Pacientes y métodos: Se estudiaron 89 pacientes con indicación de rehabilitación vestibular (RV) a lo largo del año 2009. Para el diseño del modelo de soporte audiovisual se construyó una videoteca de rutinas RV que pueden combinarse basándose en un sistema de creación de DVD para crear programas personalizados. Se valoró la incidencia de accidentes durante el tratamiento, la adherencia al mismo, la necesidad de convertirlo a un programa basado en posturografía, y la variación de las puntuaciones en la escala Dizziness Handycap Inventory (DHI) y en la agudeza visual dinámica (AVD) al finalizar el programa. Resultados: Encontramos una buena respuesta al tratamiento, tanto en lo que se refiere a la adherencia (con un incumplimiento del 5,6%), como en los parámetros clínicos, con una disminución de 33,14 puntos (de media) en el DHI y de la AVD, que disminuyó de una media de 4,24 líneas antes del tratamiento, a 1,52 con posterioridad. Discusión y conclusiones: Los resultados de este estudio muestran la posibilidad de construir una ayuda audiovisual como soporte para la creación de programas de RVDG (AU)

Introduction: To describe the creation and validation process of a new audiovisual support model for the design of guided home-based vestibular rehabilitation programs (GHVR), we introduce a prospective experimental study. Patients and methods: 89 patients who underwent vestibular rehabilitation (VR) were evaluated throughout 2009. For the model design, we built a video library with VR exercises that can be combined using DVD creation software to tailor VR protocols. Treatment incidents, adherence, need to convert to a posturography-based program and variations in the Dizziness Handicap Inventory (DHI) score and dynamic visual acuity (DVA) were assessed. Results: A good response was found, not only with respect to adherence (5.6% abandonment), but also in the clinical parameters, with a mean DHI score variation of 33.14 points, and a decrease in lines lost in the DVA test from 4.24 to 1.52 lines at the end of the treatment. Discussion and conclusions: Our study results show the possibility of building an audiovisual aid for creating GHVR programs (AU)

[Guided home-based vestibular rehabilitation assisted by audiovisual media]. / Rehabilitación vestibular domiciliaria guiada asistida por medios audiovisuales.

INTRODUCTION: To describe the creation and validation process of a new audiovisual support model for the design of guided home-based vestibular rehabilitation programs (GHVR), we introduce a prospective experimental study. PATIENTS AND METHODS: 89 patients who underwent vestibular rehabilitation (VR) were evaluated throughout 2009. For the model design, we built a video library with VR exercises that can be combined using DVD creation software to tailor VR protocols. Treatment incidents, adherence, need to convert to a posturography-based program and variations in the Dizziness Handicap Inventory (DHI) score and dynamic visual acuity (DVA) were assessed. RESULTS: A good response was found, not only with respect to adherence (5.6% abandonment), but also in the clinical parameters, with a mean DHI score variation of 33.14 points, and a decrease in lines lost in the DVA test from 4.24 to 1.52 lines at the end of the treatment. DISCUSSION AND CONCLUSIONS: Our study results show the possibility of building an audiovisual aid for creating GHVR programs.

[Pre-operative symptoms and post-operative improvement in patients diagnosed with hyperparathyroidism. Analysis of 120 consecutive cases]. / Clínica preoperatoria y mejoría postoperatoria en pacientes con diagnóstico de hiperparatiroidismo. Análisis de 120 casos consecutivos.

OBJECTIVE: To compare the pre-operative and post-operative clinical symptoms in patients diagnosed as having hyperparathyroidism and given surgical treatment, in order to prove the existence of statistically significant improvement. MATERIAL AND METHOD: We report here a retrospective study performed on 120 consecutive patients operated on following diagnosis of hyperparathyroidism between 1990 and 2003. RESULTS: Nephrolithiasis, generalized bone pain and HBP were the most common clinical manifestations. Primary hyperparathyroidisms represented 76.7 %, while secondary ones were 20.8 % and 2.5 % were tertiary. We carried out 85 adenoma removals, 30 sub-total and 5 total parathyroidectomies. We only encountered one case of recurrent palsy and about 25 % of hypocalcemias (2 of them permanent). Osteoarticular pathology and nephrolithiasis suffered by our patients clearly improved after surgery (P< .01) after 2 years of follow-up. There was no significant improvement in HBP, digestive and psychiatric pathology or pruritus. CONCLUSIONS: The improvement in quality of life for most of the patients operated on for this condition amply justifies parathyroidectomy by an experienced otolaryngology team.

Clínica preoperatoria y mejoría postoperatoria en pacientes con diagnóstico de hiperparatiroidismo. Análisis de 120 casos consecutivos / Pre-operative symptoms and post-operative improvement in patients diagnosed with hyperparathyroidism. Analysis of 120 consecutive cases

Objetivo: Comparar los síntomas clínicos preoperatorios y postoperatorios en pacientes diagnosticados de hiperparatiroidismo y sometidos a tratamiento quirúrgico, para comprobar si se produce mejoría estadísticamente significativa. Material y método: Estudio retrospectivo realizado sobre 120 pacientes consecutivos intervenidos con diagnóstico de hiperparatiroidismo entre 1990 y 2003. Resultados: La litiasis renal, los dolores óseos generalizados y la hipertensión fueron las manifestaciones clínicas más frecuentes. El 76,7 % eran hiperparatiroidismos primarios; el 20,8 %, secundarios y el 2,5 %, terciarios. Se practicaron 85 resecciones de adenoma, 30 paratiroidectomías subtotales y 5 paratiroidectomías totales. Sólo hemos constatado 1 caso de parálisis recurrencial y un 25 % de hipocalcemias (2 definitivas). Mejoraron significativamente tras la cirugía (p < 0,01) la afección osteo articular y la litiasis renal que presentaban los pacientes tras 2 años de seguimiento. No mejoraron de forma significativa la hipertensión, las enfermedades digestivas y psiquiátricas y elprurito. Conclusiones: La mejoría en la calidad de vida de la mayoría de los pacientes operados por esta enfermedad justifica sobradamente la paratiroidectomía por un equipo otorrinolaringológico experimentado (AU)

Objective: To compare the pre-operative and post-operative clinical symptoms in patients diagnosed as having hyperparathyroidism and given surgical treatment, in order to prove the existence of statistically significant improvement. Material and method: We report here a retrospective study performed on 120 consecutive patients operated on following diagnosis of hyperparathyroidism between 1990 and 2003. Results: Nephrolithiasis, generalized bone pain and HBP were the most common clinical manifestations. Primary hyperparathyroidisms represented 76.7 %, while secondary ones were 20.8% and 2.5 % were tertiary. We carried out85 adenoma removals, 30 sub-total and 5 total parathyroidectomies. We only encountered one case of recurrent palsy and about 25 % of hypocalcemias (2 of them permanent). Osteoarticular pathology and nephrolithiasis suffered by our patients clearly improved after surgery (P<0.01) after 2 years of follow-up. There was no significant improvement in HBP, digestive and psychiatric pathology or pruritus. Conclusions: The improvement in quality of life for most of the patients operated on for this condition amply justifies parathyroidectomy by an experienced otolaryngology team (AU)