Eficacia y seguridad de diferentes tratamientos con aceclofenac para el dolor crónico de espalda baja: Ensayos clínicos prospectivos, aleatorizados, de un solo centro y de etiqueta abierta

http://www.columnavertebralpediatricaygeriatrica.com.mx/academia/eficacia-y-seguridad-de-diferentes-tratamientos-con-aceclofenac-para-el-dolor-cronico-de-espalda-baja-ensayos-clinicos-prospectivos-aleatorizados-de-un-solo-centro-y-de-etiqueta-abierta/

Efficacy and Safety of Different Aceclofenac Treatments for Chronic Lower Back Pain: Prospective, Randomized, Single Center, Open-Label Clinical Trials

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28332372

https://synapse.koreamed.org/search.php?where=aview&id=10.3349/ymj.2017.58.3.637&code=0069YMJ&vmode=FULL

De:

Yang JH1,Suk KS1,Lee BH2,Jung WC1,Kang YM1,Kim JH1,Kim HS1,

Lee HM1,Moon SH3.Yonsei Med J.

2017 May;58(3):637-643. doi: 10.3349/ymj.2017.58.3.637.

Todos los derechos reservados para:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-CommercialLicense(http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

PURPOSE:

Nonsteroidal anti-inflammatory drugs are a mainstay for medical treatment of chronic lower back pain (CLBP). Increased dose intervals for medication have been associated with increased patient adherence to prescriptions. The purpose of this clinical trial was to compare the efficacy and safety of a once daily dose of aceclofenac controlled release (CR) and a twice daily dose of aceclofenac for CLBP management.

CONCLUSION:

In patients with CLBP, aceclofenac CR and aceclofenac demonstrated significant symptomatic pain relief, improvement in quality of life and functional scores. Aceclofenac CR slightly increased gastrointestinal adverse effects, such as heartburn and indigestion.

KEYWORDS:

Chronic lower back pain; NSAIDs; aceclofenac

Resumen
PROPÓSITO:
Los fármacos antiinflamatorios no esteroideos son un pilar para el tratamiento médico del dolor lumbar crónico (CLBP). Los intervalos de dosis aumentados para la medicación se han asociado con una mayor adherencia del paciente a las recetas. El propósito de este ensayo clínico fue comparar la eficacia y seguridad de una dosis diaria de aceclofenaco de liberación controlada (CR) y una dosis de aceclofenaco dos veces al día para el tratamiento del CLBP.

CONCLUSIÓN:
En los pacientes con CLBP, el aceclofenac CR y el aceclofenaco demostraron alivio significativo del dolor sintomático, mejoría en la calidad de vida y puntuaciones funcionales. Aceclofenac CR ligeramente aumento de los efectos adversos gastrointestinales, como la acidez estomacal y la indigestión.

PALABRAS CLAVE:
Dolor de espalda crónico; AINEs; Aceclofenaco

PMID:   28332372    DOI:  

10.3349/ymj.2017.58.3.637

#Dolor de espalda crónico#AINES

Factores clínicos y radiológicos relacionados con la presencia de déficit motor en el prolapso del disco lumbar: un análisis prospectivo de 70 casos consecutivos con déficit neurológico

http://www.columnayortopedia.com.mx/academia/factores-clinicos-y-radiologicos-relacionados-con-la-presencia-de-deficit-motor-en-el-prolapso-del-disco-lumbar-un-analisis-prospectivo-de-70-casos-consecutivos-con-deficit-neurologico/

Clinical and radiological factors related to the presence of motor deficit in lumbar disc prolapse: a prospective analysis of 70 consecutive cases with neurological deficit

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28331979

https://link.springer.com/article/10.1007%2Fs00586-017-5019-5

De:

Krishnan V1,Rajasekaran S2,Aiyer SN1,Kanna R1,Shetty AP1.

Eur Spine J.

2017 Mar 22. doi: 10.1007/s00586-017-5019-5. [Epub ahead of print]

Todos los derechos reservados para:

© Springer-Verlag Berlin Heidelberg 2017

Abstract

PURPOSE:

To analyse the clinic-radiological factors associated with neurological deficit following lumbar disc herniation.

CONCLUSION:

Patients with diabetes, acute presentation, central, sequestrated and superiorly migrated discs, high lumbar disc prolapse, and greater spinal canal compromise are predisposed to the presence of motor deficit.

KEYWORDS:

Clinico-radiological factors; Lumbar disc prolapse; Neurodeficit; Prognosis; Recovery

Resumen

PROPÓSITO:
Analizar los factores clínico-radiológicos asociados con el déficit neurológico después de la hernia discal lumbar.

CONCLUSIÓN:
Los pacientes con diabetes, presentación aguda, disco central, secuestrado y migración superior, prolapso del disco lumbar alto y mayor compromiso del conducto espinal están predispuestos a la presencia de déficit motor.

PALABRAS CLAVE:
Factores clínico-radiológicos; Prolapso del disco lumbar;  Neurodeficit;  Pronóstico; Recuperación

PMID:   28331979   DOI:  

10.1007/s00586-017-5019-5

#Factores clínico-radiológicos#Prolapso del disco lumbar#disco lumbar#Neurodeficit#Recuperación

Examen de la articulación de la rodilla

http://www.columnayortopedia.com.mx/academia/examen-de-la-articulacion-de-la-rodilla/

Examination of the Knee Joint

Fuente
Este artículo es originalmente publicado en:

https://youtu.be/PCRkXW57Qhs

De Y todos los derechos reservados para:

Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA

Dr. Ebraheim’s educational animated video illustrates the knee examination.
The immediate swelling is probably a large hemarthrosis. 
And if the patient stated they had a twisting injury and now they feel locking and catching which we call it mechanical symptoms and the patient gets some swelling later on then this is probably meniscal tear. 
The if the patient stated that they have pain with stairs and anterior knee pain and feel some crepitus then this is probably a patellar problem. 
If the patient said they have pain in the inside of the knee after a blow to the outside of the knee, that’s probably an MCL tear. 
If it is a dashboard injury or a fall with the foot plantar flexed then this is probably a posterior cruciate ligament ( I was texting you about itPCL) injury. 
Is a patient stated that they had a fall with the foot dorsiflexed then this is a patellar problem. 
Inspection:
Where are going to inspected the knee area for swelling, scars, ecchymosis, and muscle atrophy. 
We check the quadriceps on the right and left sides. 
Compare the condition of both quadriceps muscles to each other. 
Then ask the patient to stand and check the alignment. 
If they have varus bow legs, or valgus knock knees, 
Does the patient have a cavus foot, high arched foot, internal tibial torsion or flat foot?
That will increase the patellofemoral abnormality. 
After that we check the gait:
Check if a patient has quadriceps avoidance gait, which occurs with ACL injury. 
The patient will walk with slightly bent knee to avoid making the quadriceps work. 
Check if the patient has an anatalgic gait, which is a painful gait, it is done to lift the painful extremity quickly off the ground, it is usually caused by a hih or a knee pathology or from severe disc radiation symptoms. 
Make sure that the pain is not radiating from the spine so we ask the patient questions related to the spine. 
Straight leg raising test:
– the test is positive when the painful limb is elevated and that causes severe ciatica and radicular pain. 
Make sure you check the dorsiflexion and plantar flexion of the ankle and toes, specially the big toe. 
Chick the sensation in different dermatomes. 
Then don’t forget about the hip exam specially in children, they may have a slipped epiphysis so we need to check the internal and external rotation of the hip. 
Questions about the hip and hip Exam May detect hip pathology with pain radiating to the medial aspect of the knee. 
Range of motion:
The patient will be supine. 
Extension should be full. 
Election should be about 130°.
Compare to the other side. 
When you evaluate and compare flexion contracture on both sides you can do it supine or prone position. 
as every Orthopedic patient, you’ll also do distal neurovascular exam. 
the neurovascular exam will include the sensation, at the foot level. 
will examine the strength and the power of the muscles of the quadriceps, hamstrings, and gastrocnemius muscles. 
Don’t forget about the pulses. 
Especially in patient with knee dislocation or multiple ligamentous injury of the knee. 
You may get assistance from the ankle brachial index which should be at least 0.9.
Palpation:
palpation is usually done with the patient in the Supine position. 
The first thing I do is palpate the joint line tenderness in order to rule out a meniscal tear or arthritis. 
Then I palpate the anatomical landmarks around the knee, like the quadriceps tendon, patella and the distal pole of the patella, to see if the patient has Jumper’s knee. 
I palpate paid around the patellar tendon, tibial tubercle to rule out Osgood schlatter disease. 
Patella pathology, the most specific test is the patella apprehension test.
You put your fingers on the patella and then try to push the patella that’s really, if this causes pain and apprehension then the test is considered positive.
Evaluate patellar tracking, do full range of motion, to see if the patella will stay in the position or if it will sublux. 
Check the medial side tenderness over the medial patellofemoral ligament.
Check the patellar stability by moving the patella from side to side. 
Try to check the underside of the patella for any sign of arthritis or chondral lesion, both medially and laterally. 
Check for the hamstring muscle insertion for the as in pes anserine bursitis. 
pes anserine Bursa is located several fingers breadth below the level of the joint. 
The most important thing is not to miss him hemarthrosis or effusion in the knee joint, at that point I started looking for an ACL tear, meniscal injury, patellar dislocation or intra-articular fracture. 
Look for effusion check the suprapatellar pouch and around the knee for effusion or swelling. 
Try to push the fluid from one side to the other top to the bottom or vice versa, try to feel the fusion.

• Categoría
• Licencia

• Formación

• Licencia de YouTube estándar

#rodilla#knee#articulación#joint

Implantes Interespinosos: son los nuevos implantes mejor que la última generación? Una revisión

http://www.cirugiavertebral.com.mx/academia/implantes-interespinosos-son-los-nuevos-implantes-mejor-que-la-ultima-generacion-una-revision/


Interspinous implants: are the new implants better than the last generation? A review


Fuente

Este artículo es originalmente publicado en:


https://www.ncbi.nlm.nih.gov/pubmed/28332140


https://link.springer.com/article/10.1007%2Fs12178-017-9401-z


De:


Pintauro M1,Duffy A1,Vahedi P2,3,Rymarczuk G1,4,Heller J1.


Curr Rev Musculoskelet Med.


2017 Mar 22. doi: 10.1007/s12178-017-9401-z. [Epub ahead of print]


Todos los derechos reservados para:


© Springer Science+Business Media New York 2017


Abstract


PURPOSE OF REVIEW:


Interspinous process devices (IPDs) are used in the surgical treatment of lumbar spinal stenosis. The purpose of this review is to compare the first generation with the next-generation devices in terms of complications, device failure, reoperation rates, symptom relief, and outcome.


RECENT FINDINGS:


Thirty-seven studies were included from 2011 to 2016. Device failure occurred at a mean of 3.7%, with a lower tendency to happen with next-generation IPDs. Reoperations occurred at a lower rate with the next-generation devices, with a mean follow up of 24 months (3.7% vs. 11.1%). The clinical outcome is not influenced by the type of IPD. The long-term functionality of these devices is questionable, with radiologic changes and recurrence of symptoms often seen by 2 years following implantation. Next-generation devices do not appear to be subject to the same “bounce back” effect of symptom re-emergence after several years.


KEYWORDS:


Canal stenosis; Coflex; Interspinous device; Lumbar; Spine; X-Stop


Resumen





OBJETIVO DE LA REVISIÓN:

En el tratamiento quirúrgico de la estenosis espinal lumbar se utilizan dispositivos de proceso interespinoso (IPD). El propósito de esta revisión es comparar la primera generación con los dispositivos de próxima generación en términos de complicaciones, fallo del dispositivo, tasas de reoperación, alivio de los síntomas y resultado.





RESULTADOS RECIENTES:

Treinta y siete estudios se incluyeron de 2011 a 2016. El fallo del dispositivo se produjo en una media del 3,7%, con una menor tendencia a ocurrir con IPDs de próxima generación. Las reopera- ciones se produjeron a un ritmo menor con los dispositivos de próxima generación, con un seguimiento medio de 24 meses (3,7% frente a 11,1%). El resultado clínico no está influenciado por el tipo de IPD. La funcionalidad a largo plazo de estos dispositivos es cuestionable, con cambios radiológicos y la recurrencia de los síntomas a menudo visto en 2 años después de la implantación. Los dispositivos de la próxima generación no parecen estar sujetos al mismo efecto de “rebote” del resurgimiento de los síntomas después de varios años.





PALABRAS CLAVE:

Conducto lumbar estrecho; Coflex; Dispositivo interespinoso; Lumbar; columna; X-Stop


PMID: 28332140 DOI:


10.1007/s12178-017-9401-z



#conducto lumbar estrecho #coflex #columna

La efectividad de la terapia manual versus la cirugía de la función autoinformada, la amplitud de movimiento cervical y la fuerza de sujeción de la pinza en el síndrome del túnel carpiano: un ensayo clínico aleatorizado

http://www.medicina-rehabilitacion.com/medicina-fisica/la-efectividad-de-la-terapia-manual-versus-la-cirugia-de-la-funcion-autoinformada-la-amplitud-de-movimiento-cervical-y-la-fuerza-de-sujecion-de-la-pinza-en-el-sindrome-del-tunel-carpiano-un-ensayo-c/

The Effectiveness of Manual Therapy Versus Surgery on Self-reported Function, Cervical Range of Motion, and Pinch Grip Force in Carpal Tunnel Syndrome: A Randomized Clinical Trial

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28158963

http://www.jospt.org/doi/10.2519/jospt.2017.7090?code=jospt-site

De:

Fernández-de-Las-Peñas C, Cleland J, Palacios-Ceña M, Fuensalida-Novo S, Pareja JA, Alonso-Blanco C.

J Orthop Sports Phys Ther. 2017 Mar;47(3):151-161. doi: 10.2519/jospt.2017.7090. Epub 2017 Feb 3.

Todos los derechos reservados para:

©2017 Journal of Orthopaedic & Sports Physical Therapy

Abstract
Study Design Randomized parallel-group trial. Background Carpal tunnel syndrome (CTS) is a common pain condition that can be managed surgically or conservatively. Objective To compare the effectiveness of manual therapy versus surgery for improving self-reported function, cervical range of motion, and pinch-tip grip force in women with CTS

Conclusion Manual therapy and surgery had similar effectiveness for improving self-reported function, symptom severity, and pinch-tip grip force on the symptomatic hand in women with CTS. Neither manual therapy nor surgery resulted in changes in cervical range of motion.

Level of Evidence Therapy, level 1b. Prospectively registered September 3, 2014 at www.clinicaltrials.gov (NCT02233660). J Orthop Sports Phys Ther 2017;47(3):151-161. Epub 3 Feb 2017. doi:10.2519/jospt.2017.7090.

KEYWORDS:

carpal tunnel syndrome; cervical spine; force; manual therapy; neck; surgery

PMID:  28158963  DOI:  10.2519/jospt.2017.7090

Resumen

Diseño del estudio Ensayo aleatorio de grupos paralelos. Antecedentes El síndrome del túnel carpiano (CTS) es una condición de dolor común que se puede manejar quirúrgicamente o conservadoramente. Objetivo Comparar la efectividad de la terapia manual versus la cirugía para mejorar la función autoinformada, la amplitud del movimiento cervical y la fuerza de agarre con pinch-tip en mujeres con CTS
Conclusión La terapia y la cirugía manuales tuvieron una eficacia similar para mejorar la función autoinformada, la gravedad de los síntomas y la fuerza de agarre con pinch-tip en la mano sintomática en mujeres con CTS. Ni la terapia manual ni la cirugía resultaron en cambios en el rango de movimiento cervical.
PALABRAS CLAVE:
síndrome del túnel carpiano; columna cervical; fuerza; terapia manual; cuello; cirugía

Etiquetas: cirugía, columna cervical, cuello, fuerza, síndrome del túnel carpiano, terapia manual