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1.
Artigo em Russo | MEDLINE | ID: mdl-34719908

RESUMO

Injuries of the ligamentous apparatus of the ankle joint are one of the most common injuries of the ODA. A large number of complications and a long period of disability require the development of modern methods of physiotherapy treatment that can reduce the number of relapses and reduce the duration of rehabilitation. OBJECTIVE: Evaluation of the effectiveness of the use of electromyostimulation in motion in the treatment of post-traumatic edema of the ankle joint. MATERIAL AND METHODS: 51 athletes with post-traumatic edema of the ankle joint were examined. The main complaints were the presence of pronounced edema in the area of injury, pain, restriction of movement in the joint. The patients were randomly divided into 2 groups: the 1st group (25 patients) received treatment with electromyostimulation in motion (while performing therapeutic gymnastics); the 2nd (control) group (26 patients) performed therapeutic gymnastics recommended for the treatment of patients with lymphovenous insufficiency. The method of laser Doppler flowmetry was used to study microcirculatory disorders in the area of injury. Peripheral hemodynamics was evaluated by the RVG method. The severity of edema was assessed by measuring the circumference of the lower leg in the lower third of the injured and healthy limb. The thickness of subcutaneous fat was assessed by ultrasound. The subjective feelings of athletes were evaluated using CIVIQ-2 questionnaires and pain syndrome assessment according to VAS. RESULTS AND CONCLUSION: The use of electromyostimulation in motion in patients with post-traumatic edema of the ankle joint helped to reduce pain, relieve soft tissue edema, increase the volume of movements in the affected joint, increase motor activity and improve the quality of life.


Assuntos
Articulação do Tornozelo , Terapia por Estimulação Elétrica , Edema/etiologia , Edema/terapia , Humanos , Microcirculação , Qualidade de Vida
2.
Br J Community Nurs ; 26(Sup9): S12-S17, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34473543

RESUMO

Compression therapy is used to treat leg symptoms arising from chronic venous disease and lymphoedema. Heart failure, which is traditionally regarded as a contraindication for compression therapy, is prevalent among patients with such leg symptoms. This article aims to assess the evidence on the safety and effectiveness of compression therapy, as well as recommending the assessment and measures required when initiating compression therapy in patients with heart failure. Recent evidence suggests that initiating compression therapy in patients with stable and compensated heart failure is safe if appropriate precautionary measures are undertaken. However, there is still insufficient evidence to support the safety of compression therapy in patients with severe and decompensated heart failure. A standardised, evidence-based guideline on compression therapy in patients with heart failure will help medical and nursing professionals and improve informed consent for the patients.


Assuntos
Bandagens Compressivas , Edema/terapia , Insuficiência Cardíaca/complicações , Úlcera Varicosa/terapia , Doença Crônica , Humanos , Resultado do Tratamento
3.
Angiol Sosud Khir ; 27(3): 77-83, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34528591

RESUMO

AIM: The study was aimed at assessing efficacy and safety of micronized purified flavonoid fraction (MPFF, Detralex) in comprehensive treatment of chronic venous oedema induced by lower limb varicose veins. PATIENTS AND METHODS: We performed a post hoc analysis of the results of treatment of 708 patients included into the observational programme VAP-PRO-C3 (ClinicalTrials.gov. NCT03722836). These patients, depending on the type of treatment, were divided into 8 subgroups: MPFF (n=32); MPFF + compression (n=145); MPFF + compression + topical treatment (n=158); MPFF + compression + topical treatment + endovasal laser coagulation (n=197); MPFF + endovasal laser coagulation (n=3); MPFF + compression + endovasal laser coagulation (n=152), patients not receiving MPFF (n=16); MPFF + topical treatment (n=2). Due to paucity of the participants, from the subsequent analysis we excluded the groups MPFF + endovasal laser coagulation, patients not receiving MPFF (n=16) and MPFF + topical treatment. All further statistical data are shown for the remaining 687 patients. RESULTS: Comparing the groups of patients undergoing conservative treatment alone and those subjected to surgical intervention demonstrated no statistically significant differences in dynamics of crural oedema. In both groups at every subsequent visit there was a statistically significant decrease in the ankle volume (p<0.001). During the whole period of follow up the crural volume in patients from the group of conservative treatment totally decreased by 0.201±0.158 L and in the operated patients by 0.236±0.189 L (p=0.021). The QOL assessed by the CIVIQ-14 global index score statistically significantly improved in the unoperated patients from 31.5±19.2 to 12.0±10.1 (p<0.001). In the operated patients, the baseline and final values of the QOL of the global index score amounted to 33.4±17.8 and 7.7±9.2, respectively (p<0.001). In the groups with and without topical treatment, the baseline values of the QOL assessed by CIVIQ-14 global index score amounted to 28.5±17.4 and 36.2±18.6, respectively. During the follow-up period, we observed statistically significant positive dynamics of all parameters of quality of life. The final visit demonstrated improvement of the CIVIQ-14 global index score to 9.4±9.2 in patients without topical treatment and 10.1±10.4 in those receiving topical treatment (p=0.367), with the mean value of this parameter during treatment in both groups decreased significantly (p<0.001). A statistically significant decrease in the ankle volume in both groups was registered at every visit, finally amounting to 0.223±0.166 L and 0.248±0.174 L (p=0.118) for patients not receiving and receiving topical treatment, respectively. In groups of patients not receiving and those receiving compression therapy, the baseline values of the QOL assessed by CIVIQ-14 global index score amounted to 21.4±14.2 and 33.1±18.5 (p<0.001), respectively. At the final visit, these indices statistically significantly (p<0.001) decreased to 7.3±9.1 and 9.9±9.9 (p=0.106). Compared with the baseline values, the ankle volume at the final visit in groups of patients with and without compression therapy statistically significantly decreased by 0.187±0.14 L and 0.238±0.17 L respectively (p=0.204). During the study, there were no adverse events related to the administration of MPFF and use of Detragel. CONCLUSION: MPFF and Detragel appear to be effective and safe components of comprehensive conservative therapy of chronic oedema induced by primary varicose veins of lower extremities.


Assuntos
Varizes , Insuficiência Venosa , Doença Crônica , Edema/diagnóstico , Edema/etiologia , Edema/terapia , Humanos , Qualidade de Vida , Resultado do Tratamento , Varizes/complicações , Varizes/diagnóstico , Varizes/terapia , Veias , Insuficiência Venosa/complicações , Insuficiência Venosa/diagnóstico , Insuficiência Venosa/terapia
5.
Medicine (Baltimore) ; 100(28): e26639, 2021 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-34260560

RESUMO

ABSTRACT: Even healthy individuals often encounter leg venous symptoms such as heaviness, pain, and swelling especially after prolonged standing work. Intermittent pneumatic compression (IPC) is a widely used simple therapy for preventing deep vein thrombosis and for treating lymphedema and chronic venous insufficiency. However, IPC has not been evaluated for its effect in relieving venous symptoms of healthy people.This was single center, cross-over study to investigate the effect of IPC for 20 healthy volunteers who usually stand on duty and complain of leg pain and swelling. The primary outcome was pain (measured using a visual analogue scale) and secondary outcomes were leg circumference and volume. Three different interventions included natural rest, sequential mode of IPC, and circular mode of IPC. Outcomes were measured before work and immediately after work (T1), after 30 minutes of intervention (T2), and 30 minutes of rest after intervention (T3).Pain and leg circumferences were significantly improved at T2 and T3 compared with those at T1. Sequential and circular IPC led to significantly greater improvement in pain and leg circumferences than just natural rest, but there was no difference in its effect according to the 2 modes of IPC. Leg volume was reduced significantly at T2 and T3 as compared with T1 in all 3 interventions, but effects did not differ among 3 intervention groups.IPC is effective for reducing leg pain and circumferences more than natural rest in healthy adults with prolonged standing work, without causing adverse events.


Assuntos
Edema/terapia , Dispositivos de Compressão Pneumática Intermitente , Perna (Membro)/fisiopatologia , Manejo da Dor/métodos , Posição Ortostática , Adulto , Estudos Cross-Over , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saúde do Trabalhador , Medição da Dor
6.
Artigo em Russo | MEDLINE | ID: mdl-34223754

RESUMO

In the conditions of increasingly stringent anti-doping rules, the development of new non-drug methods of treatment and rehabilitation of athletes is of particular importance. OBJECTIVE: Development of new methods of medical rehabilitation of athletes after injury. MATERIAL AND METHODS: Thirty-three athletes with knee injuries were examined. The main complaints were the presence of pronounced edema in the area of injury. All patients were randomly divided into 2 groups: in group 1 (16 patients) lymphatic drainage kinesis-taping was performed; in the 2nd group (17 patients) - complex treatment including lymphatic drainage kinesis-taping and low-frequency pulse magnetic therapy. Using laser Doppler flowmetry a study of microcirculatory disorders in the area of injury was carried out. The severity of edema was assessed by measuring the circumference of the knee joint of the diseased and healthy limbs. The assessment of the subjective feelings of athletes using questionnaires CIVIQ2 andVAS. RESULTS AND CONCLUSION: Based on the obtained subjective and objective data, a medical complex was developed using lymphatic drainage kinesis-taping and low-frequency pulse magnetic therapy, which affects different steps in the pathogenesis of edema formation. Data obtained resultedin more pronounced positive effect during complex treatment compared with monotherapy with kinesis-taping.


Assuntos
Fita Atlética , Cinese , Atletas , Edema/etiologia , Edema/terapia , Humanos , Extremidade Inferior , Fenômenos Magnéticos , Microcirculação
7.
J Vasc Nurs ; 39(2): 43-46, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34120697

RESUMO

Lower limb edema with its accompanying subjective ailments has been increasingly frequent in gravid women and in the postpartum period. The management is essentially non-interventional based on compression therapy (CT) with physical exercise adapted to the severity of venous disease and edema. A case of lower limb edema in a woman in the thirty third week of pregnancy was described. CT including compressive bandaging (CB) by short-stretch bandage and compression garments (CG) with physical activity was applied. Edema volume reduction, changes in consistency from hard to mild in palpation and reduction of accompanying ailments by use of CB after two weeks were observed. Further improvement by use of CG before and after delivery, and 3 years later was confirmed. Compression and physical exercise have a positive impact on edema reduction and leg symptoms intensity during pregnancy and should be recommended.


Assuntos
Bandagens , Edema , Bandagens Compressivas , Edema/terapia , Exercício Físico , Feminino , Seguimentos , Humanos , Extremidade Inferior , Gravidez
8.
J Orthop Surg Res ; 16(1): 369, 2021 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-34107978

RESUMO

BACKGROUND: Extracorporeal shock wave therapy (ESWT) has been used for various pathologies associated with bone marrow oedema (BME). However, it is still not clear whether ESWT may be favourable in the treatment of BME. Therefore, the aim of this systematic review was to assess the efficacy of ESWT for the treatment of BME. METHODS: MEDLINE was searched for relevant literature with no time constraints. Both randomized and non-randomized trials were included. Case reports and conference abstracts were excluded. Titles and abstracts were screened and full-text articles of included studies were retrieved. Data on the effect of ESWT on pain, function, and the BME area on magnet resonance imaging were extracted. RESULTS: Pain, function, and magnet resonance imaging results all improved across the studies - regardless of whether it was a randomized or non-randomized study. This effect was consistent across multiple pathologies such as osteonecrosis of the femoral head, BME associated with knee osteoarthritis, Kienböck's disease, and osteitis pubis. The meta-analysis showed that pain (after 1 month: weighted mean difference (WMD) = - 2.23, 95% CI - 2.58 to - 1.88, P < 0.0001; after 3-6 month: WMD = - 1.72, 95% CI - 2.52 to - 0.92, P < 0.00001) and function (after 1 month: WMD = - 1.59, 95% CI - 2.04 to - 1.14, P < 0.0001; after 3-6 month: WMD = - 2.06, 95% CI - 3.16 to - 0.96, P = 0.0002; after ≥ 12 month: WMD = - 1.20, 95% CI - 1.83 to - 0.56, P = 0.0002) was reduced in terms of ESWT treatment compared to a control group. CONCLUSIONS: Based on the available evidence, ESWT may be an adequate option for conservative therapy in pathologies involving BME. TRIAL REGISTRATION: PROSPERO, CRD42021201719 . Registered 23 December 2020.


Assuntos
Doenças Ósseas/terapia , Medula Óssea , Tratamento Conservador/métodos , Edema/terapia , Tratamento por Ondas de Choque Extracorpóreas/métodos , Doenças Ósseas/etiologia , Edema/etiologia , Feminino , Necrose da Cabeça do Fêmur/complicações , Humanos , Masculino , Osteoartrite do Joelho/complicações , Resultado do Tratamento
9.
J Wound Care ; 30(5): 400-412, 2021 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-33979221

RESUMO

OBJECTIVE: Compression therapy is the cornerstone of therapeutic management of patients with chronic venous insufficiency (CVI). This study aimed to evaluate the efficacy and safety of a multicomponent compression system in an unselected population of patients with CVI problems under real-life conditions. METHOD: A prospective, multicentre, observational study with a multicomponent two-bandage compression system (UrgoK2, Laboratoires Urgo, France) was conducted in 103 centres in Germany. Main outcomes included wound healing rate, wound healing progression, assessment of oedema and ankle mobility, local tolerability and acceptance of the compression therapy. RESULTS: A total of 702 patients with venous leg ulcers (VLU) and/or with lower limb oedema due to CVI were treated with the evaluated system for a mean (±standard deviation) duration of 27±17 days. By the last visit, 30.9% of wounds had healed and 61.8% had improved. Limb oedema was resolved in 66.7% of patients and an improvement of ankle mobility was reported in 44.2% of patients. The skin condition under the compression therapy was also considered as improved in 73.9% of patients and a substantial reduction of pain was achieved, both in number of patients reporting pain and in pain intensity. Compression therapy with the evaluated system was 'very well' or 'well' tolerated and 'very well' or 'well' accepted by >95% of patients. These positive outcomes were in line with the general opinion of physicians on the evaluated compression bandages, which were judged 'very useful' or 'useful' for >96.6% of patients. Similar results were reported regardless of the treated condition, VLU and/or limb oedema. CONCLUSION: Real-life data documented in this large observational study of non-selected patients receiving compression therapy in daily practice confirm the benefits and safety profile of the evaluated compression system. This study also confirms the high-level of performance and acceptability of the system, regardless of the characteristics of the wounds or patients at initiation of the treatment. The data support the use of this multicomponent compression system as one first-line intervention in patients with symptoms caused by CVI.


Assuntos
Bandagens Compressivas , Edema/terapia , Úlcera Varicosa/terapia , Insuficiência Venosa/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , França , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Insuficiência Venosa/complicações , Cicatrização
10.
Clin Ter ; 172(3): 231-235, 2021 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-33956043

RESUMO

Objective: The definition of neuromuscular taping (NMT) has yet to be clearly analysed as a possible treatment for diabetic foot. Case studies, theoretical analysis and results of existing research may lead to varying perceptions on the definition of NMT and its possible effects on diabetic foot. This article aims to analyse the definition of the NMT concept and furthermore as a basis for future research development on diabetic foot. Methods: The procedure for reference source search include the principal data bases using "neuromuscular taping" and "diabetic foot" keywords for the period of 2010-2019. The concept analysis uses an 8-step approach with the Walker and Avant's method. Conclusions: NMT is a decompression application of an elastic tape on the skin on the diabetic foot that has the effect of reducing the inflammatory response, improving vascularity and neuromusculoskel-etal function. It aims to improve neuromusculoskeletal and lymphatic system functioning due to the presence of wrinkles, indicating dila-tion, with local effects on the sensorimotor and proprioceptive senses in conditions of care, rehabilitation and injury. Results: Analysis of the NMT concept on diabetic foot obtained attributes of elastic tape, skin, pain, edema, injury, sensorimotor, circulation, drainage, relaxation, local, proprioceptive, motion func-tion, strength, contraction, stabilisation, reflex, rehabilitation, care, musculoskeletal, nerve, muscles, tendons, fascia, joints, lymphatic, longitudinal, wrinkles. There were four groups of attributes, namely inflammatory response, vascularity, neuromusculoskeletal function and musculoskeletal system. NMT application benefits for diabetic foot can be attributed to improving walking function, leg position, decreasing pain response, improving body function index, improving leg muscle strength and motor function, increasing range of movement (ROM), maintaining stability of leg joint function, preventing injury, increas-ing strength and improving position of ankle joints, reducing stiffness, reducing edema and helping wound healing processes.


Assuntos
Fita Atlética , Pé Diabético/terapia , Diabetes Mellitus/terapia , Edema/terapia , Humanos , Músculo Esquelético , Caminhada/fisiologia
11.
Phys Ther ; 101(9)2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34003282

RESUMO

OBJECTIVE: The aim of this case report was to describe the use of complete decongestive therapy (CDT) with a new approach in the management of a male with facial edema related to Morbus Morbihan Syndrome (MMS). METHODS: An 18-year-old male with MMS after acne treatment was the subject of this case report. Volume assessment was performed with distance measurements of the facial area using standard reference points, the overflow method, and the measurement of the percentage of subdermal fluid. Participant-reported symptoms of lymphedema (feeling of swelling and tightness) and body image perception were evaluated with the visual analogue scale, and the severity of anxiety was evaluated with the State and Trait Anxiety Inventory. In addition, the participant's perception of improvement was determined using a Likert-type scale. Evaluations were performed at baseline, week 4 (during the treatment), and week 8 (immediately after treatment). CDT was applied to the participant in a total of 24 sessions, 3 d/wk for 8 weeks. RESULTS: Compared with the baseline measurement, the facial distances (tragus-mental cavity, tragus-mouth corner, mandibula-nasal canal, mandibula-internal orbita, mandibula-external orbita, mental cavity-internal orbita, mental cavity-mandibula, right-left tragus, and hairline in the forehead-mental cavity), the volume, and the percentage of subdermal fluid of facial area were decreased at the week 4 and 8 measurements. The anxiety score, participant reports of feelings of swelling and tightness, and body image perception improved after the 8 weeks of treatment compared with baseline. CONCLUSION: This case report described the use of CDT in treating edema and participant symptoms in an individual with facial lymphedema related to MMS. Body image and level of anxiety improved.


Assuntos
Edema/terapia , Dermatoses Faciais/terapia , Linfedema/terapia , Drenagem Linfática Manual/métodos , Rosácea/terapia , Adolescente , Drenagem/métodos , Edema/complicações , Dermatoses Faciais/etiologia , Humanos , Linfedema/complicações , Masculino , Rosácea/complicações , Resultado do Tratamento
12.
J Drugs Dermatol ; 20(4): 475-476, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33852245

RESUMO

This case series demonstrates an exaggerated form of the clinical presentation of a known distressing late complication of retained hyaluronic acid filler – the “pale puffy pillow.” This presentation is often, unfortunately for the patient, misdiagnosed as festoons. However, the correction with liberal hyaluronidase is simple. Additionally, we have demonstrated that ablative fractional carbon dioxide laser resurfacing is an excellent tool that may be utilized after hyaluronidase to correct the residual skin laxity.J Drugs Dermatol. 20(4):475-476. doi:10.36849/JDD.5509.


Assuntos
Blefaroplastia/efeitos adversos , Edema/terapia , Ácido Hialurônico/efeitos adversos , Hialuronoglucosaminidase/administração & dosagem , Lasers de Gás/uso terapêutico , Adulto , Idoso , Blefaroplastia/métodos , Edema/etiologia , Pálpebras/efeitos dos fármacos , Pálpebras/efeitos da radiação , Feminino , Humanos , Ácido Hialurônico/administração & dosagem , Ácido Hialurônico/antagonistas & inibidores , Pessoa de Meia-Idade , Estudos Retrospectivos , Envelhecimento da Pele/efeitos dos fármacos , Resultado do Tratamento
13.
Phys Ther Sport ; 49: 243-249, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33813154

RESUMO

OBJECTIVE: Investigate effectiveness of cryotherapy on pain intensity, swelling, range of motion, function and recurrence in acute ankle sprain. METHODS: Searches were conducted on six databases for randomized or quasi-randomized controlled trials (RCTs) evaluating effectiveness of cryotherapy for pain intensity, swelling, range of motion, function and recurrence in acute ankle sprain. Selection of trials, data extraction and methodological quality assessment of included trials were conducted independently by two reviewers with discrepancies resolved by a third reviewer. Estimates were presented as mean differences (MDs) with 95% confidence intervals (CIs). The quality of the evidence was assessed using the Grading of Recommendations Assessment (GRADE) approach. RESULTS: Two RCTs with high risk of bias were included. Both evaluated the additional effects of cryotherapy, comparing cryotherapy combined with other intervention versus other intervention stand-alone. Uncertain evidence shows that cryotherapy does not enhance effects of other intervention on swelling (MD = 6.0; 95%CI: 0.5 to 12.5), pain intensity (MD = -0.03; 95%CI: 0.34 to 0.28) and range of motion (p > 0.05). CONCLUSIONS: Current literature lacks evidence supporting the use of cryotherapy on management of acute ankle sprain. There is an urgent call for larger high-quality randomized controlled trials.


Assuntos
Traumatismos do Tornozelo/terapia , Crioterapia/métodos , Edema/terapia , Manejo da Dor , Amplitude de Movimento Articular , Adolescente , Adulto , Edema/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/epidemiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Recuperação de Função Fisiológica , Recidiva , Adulto Jovem
14.
Eur J Dermatol ; 31(2): 225-232, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33871363

RESUMO

BACKGROUND: Atopic dermatitis (AD) is a multifactorial long-standing inflammatory skin disease with a high incidence worldwide in both adults and children. According to the recognized correlation between skin and intestine-the so-called "gut-skin axis"-gut unbalances can affect skin by inducing systemic inflammation and triggering dermatological diseases such as AD. OBJECTIVES: To evaluate the efficacy of a food supplement containing selected strains of probiotics in ameliorating AD symptoms and skin conditions in adult volunteers. MATERIALS & METHODS: Eighty adult subjects showing mild-to-severe AD, skin dryness, desquamation, erythema and itching were enrolled in a randomized controlled trial to receive, for 56 days, a placebo or a mixture of lactobacilli (L. plantarum PBS067, L. reuteri PBS072 and L. rhamnosus LRH020). The latter was chosen according to the patients' production of post-biotic metabolites and B-group vitamins, anti-inflammatory and anti-oxidant capacity and anti-microbial activity. Clinical and instrumental dermatological evaluation was performed at T0d, T28d and T56d, and then at T84d (after a one-month wash-out). Inflammatory cytokine levels from skin tape stripping, sampled close to AD lesions at T0d and T56d, were also measured. RESULTS: Subjects receiving the probiotic mixture showed an improvement in skin smoothness, skin moisturization, self-perception, and a decrease in SCORAD index as well as in the levels of inflammatory markers associated with AD at T28d, with a positive trend up to T56d which was maintained at T84d. CONCLUSION: Administration of selected probiotic strains resulted in a fast and sustained improvement in AD-related symptoms and skin conditions.


Assuntos
Dermatite Atópica/fisiopatologia , Dermatite Atópica/terapia , Probióticos/uso terapêutico , Adulto , Quimiocina CCL17/metabolismo , Citocinas/metabolismo , Dermatite Atópica/complicações , Dermatite Atópica/psicologia , Método Duplo-Cego , Edema/etiologia , Edema/terapia , Eritema/etiologia , Eritema/terapia , Feminino , Humanos , Masculino , Prurido/etiologia , Prurido/terapia , Autoimagem , Índice de Gravidade de Doença , Fenômenos Fisiológicos da Pele , Avaliação de Sintomas , Fatores de Tempo , Fator de Necrose Tumoral alfa/metabolismo , Perda Insensível de Água
15.
J Foot Ankle Surg ; 60(3): 523-528, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33573900

RESUMO

To determine the validity and safety of extracorporeal shock wave therapy (ESWT) in the treatment of bone marrow edema syndrome (BMES) of the foot. Twenty patients diagnosed as foot BMES in our Center were followed and treated by ESWT for 1 to 2 courses. The target of the ESWT treatment was the most obvious foot tenderness, or the most obvious part of bone edema on magnetic resonance imaging (MRI). One course of ESWT was 1 time/week, 5 times in total, with the shock wave energy flow density 0.18 mJ/mm2. The visual analog scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) scores of the foot were recorded before treatment, at 3 months after treatment and the last follow-up; the areas of BME before treatment and at the last follow-up were measured by the fat suppression MRI. Complications during treatment were also recorded. Twenty follow-up patients were obtained. Compared with the pretreatment, the patients had significant improvement in various indicators at 3 months after treatment (p < 0.01). The sagittal MRI at the last follow-up showed that the BME area decreased significantly (p < 0.01). Two patients developed transient erythema on their skin after treatment and alleviated after 2 days of rest. No serious complications were found during treatment. Our findings show that for patients with foot BMES, the use of ESWT treatment can effectively relieve local pain, improve the motor function of the foot and ankle. Two courses of treatment may be required for some patients.


Assuntos
Tratamento por Ondas de Choque Extracorpóreas , Medula Óssea , Edema/etiologia , Edema/terapia , Humanos , Estudos Retrospectivos , Resultado do Tratamento
16.
J Orthop Surg Res ; 16(1): 21, 2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-33413520

RESUMO

BACKGROUND: There is now ample evidence suggesting that extracorporeal shock wave therapy (ESWT) can improve hip mobility and reduce pain in patients with osteonecrosis of the femoral head (ONFH). The ability of ESWT to cure bone marrow edema syndrome (BMES) in patients with ONFH, 12 weeks after the initial course of ESWT, needs to be verified further and more relevant clinical research-based evidence should be consolidated. This study aimed to evaluate the efficacy of ESWT for BMES caused by ONFH. METHODS: This retrospective cohort study included 67 patients with BMES caused by ONFH who were participating in a rehabilitation program as outpatients. Before and after ESWT, the area of femoral bone marrow edema was evaluated by magnetic resonance imaging (MRI), and the Harris score and Charnley score were evaluated as hip pain and function indicators. RESULTS: After ESWT, MRI revealed that the area of bone marrow edema decreased from 984.6 ± 433.2 mm2 to 189.7 ± 214.4 mm2 (P < 0.0001). The Harris score increased from 42.2 ± 9.1 to 77.7 ± 10.8 points (P < 0.0001). The Charnley score increased from 7.3 ± 1.4 to 12.0 ± 1.7 (P < 0.0001). ESWT was effective in treating BMES in 98.5% of the cases. CONCLUSIONS: This study demonstrated that ESWT can effectively treat BMES caused by ONFH and can aid in pain relief and functional recovery in patients with ONFH. Thus, ESWT should be included in the classic physical therapy regimen for patients with ONFH and BMES.


Assuntos
Doenças da Medula Óssea/etiologia , Doenças da Medula Óssea/terapia , Edema/terapia , Tratamento por Ondas de Choque Extracorpóreas , Necrose da Cabeça do Fêmur/complicações , Necrose da Cabeça do Fêmur/terapia , Adulto , Idoso , Edema/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Síndrome , Resultado do Tratamento
17.
Iran J Kidney Dis ; 1(1): 69-72, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33492308

RESUMO

The objective of our paper is to reemphasize the importance of critical thinking in clinical practice and education in the field of internal medicine using the example of edema. We provide an in-depth and interactive investigation of physiological concepts as a foundation for the understanding of body fluid dynamics. Four fundamental concepts described are the hydrostatic and oncotic pressure gradients, capillary permeability, and lymphatic drainage. Furthermore, we visit the causes of edema in nephrotic syndrome. Traditional teaching considers hypoalbuminemia as a primary cause of edema formation in nephrotic syndrome. It has been proven that other etiologies causing edema include salt and water retention by the kidneys and a possible increase in capillary permeability are more important causes in the development of edema in nephrotic syndrome.


Assuntos
Líquidos Corporais , Síndrome Nefrótica , Edema/diagnóstico , Edema/etiologia , Edema/terapia , Humanos , Rim , Síndrome Nefrótica/complicações , Síndrome Nefrótica/diagnóstico , Síndrome Nefrótica/terapia
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