RESUMO
BACKGROUND: Complex regional pain syndrome (CRPS) is a disorder that is often challenging to treat and can be associated with a prolonged course of severe pain. Therapy of CRPS remains controversial; the pain often can be very difficult to control, and treatment includes medications, physical therapy, regional anesthesia, and neuromodulation. AIM: We evaluated Scrambler Therapy(®) (ST) in terms of efficacy, safety, and durability of treatment effect in patients suffering from CRPS. MATERIALS AND METHODS: We report the response to ST in four patients with CRPS referred to the Pain Center of Bambino Gesù Children's Hospital. The patients previously did not respond to conventional and nonconventional medical treatments. RESULTS: The treatment with ST was found effective in all four of our patients; they obtained pain relief for long periods and an improvement in their quality of life. We observed a progressive improvement with complete disappearance of neuropathic pain. Patients also reported a muscle strength increase that allowed them to resume normal daily activities. DISCUSSION AND CONCLUSION: We conclude that ST may offer a therapeutic opportunity for patients with neuropathic pain resulting from CRPS, without side effects and with minimal discomfort during treatment. The observed pain relief indicates that ST could be an effective option for such patients.
Assuntos
Síndromes da Dor Regional Complexa/terapia , Terapia por Estimulação Elétrica/métodos , Manejo da Dor/métodos , Feminino , Humanos , Masculino , Medição da Dor/métodos , Qualidade de VidaRESUMO
STUDY OBJECTIVES: Evaluation of different types of tracheostomy tubes in patients with neuromuscular disorders. DESIGN: Review of past charts of 49 patients with DMD. SETTING: Intensive care unit of Children's Hospital-Bambino Gesù Rome-Palidoro, Italy CONCLUSIONS: Our findings favour the use of flexible tracheostomy tubes in reducing the risk of developing tracheal haemorrhages.
Assuntos
Brônquios/lesões , Hemorragia/etiologia , Distrofias Musculares/complicações , Traqueia/lesões , Traqueostomia/efeitos adversos , Adulto , Broncoscópios , Desenho de Equipamento , Hemorragia/prevenção & controle , Humanos , Doença Iatrogênica/prevenção & controle , Distrofias Musculares/terapia , Maleabilidade , Estudos Retrospectivos , Traqueostomia/instrumentaçãoRESUMO
We present a case of a 16-month old previously healthy child who was hospitalized because of an acute respiratory insufficiency most likely caused by a viral infection and who then developed a severe acute quadriplegic myopathy (AQM). Initial clinical symptoms were respiratory acidosis, dypnea, intense wheezing, and deterioration of the level of consciousness, which required orotracheal intubation and mechanical ventilation. We administered neuromuscular blocking agents, corticosteroids, and antibiotics. After 9 days the clinical picture improved. An attempt to wean from the ventilator failed. We diagnosed AQM. This paper discusses AQM and its clinical importance.