Utilidad del kinesiotaping en el tratamiento de los puntos gatillo miofasciales: revisión sistemática / Usefulness of kinesiotaping in the treatment of myofascial trigger points: systematic review

OBJETIVO: Evaluar la utilidad y eficacia del kinesiotaping en el tratamiento de los puntos gatillo miofasciales causados por el síndrome de dolor miofascial. ESTRATEGIA DE BÚSQUEDA: Se realizó una búsqueda bibliográfica en Pubmed, ScienceDirect, Web of Science, Cinhal, Scopus y Cochrane Library, atendiendo a la siguiente estrategia de búsqueda: (Kinesiotape OR Taping OR Kinesiotaping OR Tape) AND («Trigger points»). SELECCIÓN DE ESTUDIOS: Se seleccionaron aquellos artículos que databan entre 2015 y marzo de 2020, que fuesen ensayos clínicos, que estudiaran la eficacia del kinesiotaping en los puntos gatillo en al menos uno de los grupos de intervención y que tuvieran una puntuación mínima de 5/10 en Escala PEDro. SÍNTESIS DE RESULTADOS: Los artículos analizados poseen un total de 671 pacientes. Todos los artículos muestran mejorías en los parámetros de dolor, rango de movimiento, calidad de vida y fuerza muscular. Se observan diferencias significativas en las comparaciones intragrupales y en las intergrupales con grupos control, grupos tratados con kinesiotaping placebo (sin tensión). Pero no se hallaron diferencias significativas en las comparaciones con otros métodos de fisioterapia como la punción seca. CONCLUSIONES: El kinesiotaping parece ser una buena opción para el tratamiento del dolor, la limitación del rango de movimiento y las limitaciones en las actividades diarias que genera un punto gatillo miofascial. Sin embargo, otras técnicas resultan mucho más efectivas en estos casos. La calidad metodológica de los estudios es mejorable, por lo que se requiere nuevos ensayos clínicos que aporten evidencias científicas sólidas

OBJECTIVE: The usefulness and effectiveness of kinesiotaping is evaluated in the treatment of the myofascial trigger points caused by myofascial pain syndrome. SEARCH STRATEGY: A literature search in Pubmed, ScienceDirect, Web of Science, Cinhal, Scopus and Cochrane Library was performed with the following search strategy: (Kinesiotape OR Tape OR Taping OR Kinesiotaping) AND ("Trigger point"). ARTICLE SELECTION: Articles dating from 2015 to March 2020 that were clinical trials, that studied the efficacy of kinesiotaping at trigger points in at least one of the intervention groups and that had a minimum score of 5/10 in the PEDro scale were selected. SYNTHESIS OF RESULTS: The analysed articles have a total of 671 patients. All articles show improvement in the parameters of pain, range of motion, quality of life and muscle strength. Significant differences are observed in intragroup and intergroup comparisons with control groups, placebo kinesiotaping (no tension) treated groups. But no significant differences were found in the comparisons with other physiotherapy methods such as dry puncture. CONCLUSIONS: Kinesiotaping seems to be a good option for the treatment of pain, limitation of range of movement and limitations in daily activities that generates a myofascial trigger point. However, other techniques are much more effective in these cases. The methodological quality of the studies could be improved, therefore new clinical trials are required to provide solid scientific evidence

Assessment of indicators of vitamin A status in non-cirrhotic chronic hepatitis C patients

Subjects with chronic liver disease are susceptible to hypovitaminosis A due to several factors. Therefore, identifying patients with vitamin deficiency and a requirement for vitamin supplementation is important. Most studies assessing vitamin A in the context of hepatic disorders are conducted using cirrhotic patients. A cross-sectional study was conducted in 43 non-cirrhotic patients with chronic hepatitis C to evaluate markers of vitamin A status represented by serum retinol, liver retinol, and serum retinol-binding protein levels. We also performed the relative dose-response test, which provides an indirect estimate of hepatic vitamin A reserves. These vitamin A indicators were assessed according to the stage of liver fibrosis using the METAVIR score and the body mass index. The sample study was predominantly composed of male subjects (63%) with mild liver fibrosis (F1). The relative dose-response test was <20% in all subjects, indicating vitamin A sufficiency. Overweight or obese patients had higher serum retinol levels than those with a normal body mass index (2.6 and 1.9 µmol/L, respectively; P<0.01). Subjects with moderate liver fibrosis (F2) showed lower levels of serum retinol (1.9 vs 2.5 µmol/L, P=0.01) and retinol-binding protein levels compared with those with mild fibrosis (F1) (46.3 vs 67.7 µg/mL, P<0.01). These results suggested an effect of being overweight on serum retinol levels. Furthermore, more advanced stages of liver fibrosis were related to a decrease in serum vitamin A levels.

Late emergence of A594V and L595W mutations related to ganciclovir resistance in a patient with HCMV retinitis and long-term HIV progression

The emergence of ganciclovir (GCV) resistance during the treatment of human cytomegalovirus (HCMV) infection is a serious clinical challenge, and is associated with high morbidity and mortality. In this case report, we describe the emergence of two consecutive mutations (A594V and L595W) related to GCV resistance in a patient with HCMV retinitis and long-term HIV progression after approximately 240 days of GCV use. Following the diagnosis of retinitis, the introduction of GCV did not result in viral load reduction. The detected mutations appeared late in the treatment, and we propose that other factors (high initial HCMV load, previous GCV exposure, low CD4+ cell count), in addition to the presence of resistance mutations, may have contributed to the treatment failure of HCMV infection in this patient.