RESUMO
Abstract Introduction and objectives: Myofascial Pain Syndrome (MPS) of the Quadratus Lumborum muscle (QL) is a frequent cause of chronic low back pain. With this study, we aimed to assess the efficacy of ultrasound-guided infiltration with 0.25% levobupivacaine and 40 mg triamcinolone for MPS of the QL. Methods: Observational and retrospective study of participants submitted to ultrasound-guided infiltration of the QL muscle from January 1, 2015 to June 31, 2019. Pain intensity was assessed using the five-point pain Numeric Rating Scale (NRS): pre-intervention, at 72 hours, 1 month, 3 months and 6 months post-intervention. Additional data collected were demographic characteristics, opioid consumption, and adverse effects. Results: We assessed 90 participants with mean age of 55.2 years. Sixty-eight percent of participants were female. Compared to the pre-intervention assessment, there was an improvement in pain at 72 hours (Mean Difference [MD = 3.085]; 95% CI: 2.200-3.970, p < 0.05), at the 1st month (MD = 2.644; 95% CI: 1.667-3.621, p < 0.05), at the 3rdmonth (MD = 2.017; 95% CI: 0.202-2.729, p < 0.05) and at the 6th month (MD = 1.339; 95% CI 0.378-2.300, p < 0.05), post-intervention. No statistically significant differences in opioid consumption were observed. No adverse effects associated with the technique were reported. Conclusions: Ultrasound-guided infiltration of the QL muscle is a safe and effective procedure for the treatment of pain in the QL MPS within 6 months post-intervention.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Neuralgia Facial/tratamento farmacológico , Bloqueio Nervoso/métodos , Dor , Triancinolona , Estudos Retrospectivos , Ultrassonografia de Intervenção/métodos , Levobupivacaína , Analgésicos OpioidesRESUMO
The aim of the present work was to modify the exuded gum of Sterculia striata tree by an amination reaction. The viscosity and zero potential of the chicha gum varied as a function of pH. The modification was confirmed by X-ray diffraction (XRD), infrared spectroscopy (FTIR), size exclusion chromatography (SEC), zeta potential, thermogravimetric analysis (TG), and differential scanning calorimetry (DSC). Furthermore, the chemical modification changed the molar mass and surface charge of the chicha gum. In addition, the gums were used in tests for ex vivo mucoadhesion strength, antibacterial activity against the standard strain of Staphylococcus aureus (ATCC 25923), inhibitory activity of α-glucosidase, antioxidant capacity, and viability of Caco-2 cells. Through these tests, it was found that amination caused an increase in the mucoadhesive and inhibitory activity of chicha gum against the bacterium Staphylococcus aureus. In addition, the gums (pure and modified) showed antioxidant capacity and an inhibitory effect against the α-glucosidase enzyme and did not show cytotoxic potential.
Assuntos
Antioxidantes , alfa-Glucosidases , Humanos , Antioxidantes/farmacologia , Células CACO-2 , Antibacterianos/farmacologia , Antibacterianos/química , Difração de Raios X , Gomas Vegetais/farmacologia , Gomas Vegetais/química , Espectroscopia de Infravermelho com Transformada de FourierRESUMO
INTRODUCTION AND OBJECTIVES: Myofascial Pain Syndrome (MPS) of the Quadratus Lumborum muscle (QL) is a frequent cause of chronic low back pain. With this study, we aimed to assess the efficacy of ultrasound-guided infiltration with 0.25% levobupivacaine and 40.ßmg triamcinolone for MPS of the QL. METHODS: Observational and retrospective study of participants submitted to ultrasound-guided infiltration of the QL muscle from January 1, 2015 to June 31, 2019. Pain intensity was assessed using the five-point pain Numeric Rating Scale (NRS): pre-intervention, at 72.ßhours, 1 month, 3 months and 6 months post-intervention. Additional data collected were demographic characteristics, opioid consumption, and adverse effects. RESULTS: We assessed 90 participants with mean age of 55.2 years. Sixty-eight percent of participants were female. Compared to the pre-intervention assessment, there was an improvement in pain at 72.ßhours (Mean Difference [MD.ß=.ß3.085]; 95% CI: 2.200...3.970, p.ß<.ß0.05), at the 1st month (MD.ß=.ß2.644; 95% CI: 1.667...3.621, p.ß<.ß 0.05), at the 3rdmonth (MD.ß=.ß2.017; 95% CI: 0.202...2.729, p.ß<.ß0.05) and at the 6th month (MD.ß=.ß1.339; 95% CI 0.378...2.300, p.ß<.ß0.05), post-intervention. No statistically significant differences in opioid consumption were observed. No adverse effects associated with the technique were reported. CONCLUSIONS: Ultrasound-guided infiltration of the QL muscle is a safe and effective procedure for the treatment of pain in the QL MPS within 6 months post-intervention.
Assuntos
Síndromes da Dor Miofascial , Bloqueio Nervoso , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Levobupivacaína , Triancinolona , Estudos Retrospectivos , Analgésicos Opioides , Bloqueio Nervoso/métodos , Ultrassonografia de Intervenção/métodos , Dor , Síndromes da Dor Miofascial/tratamento farmacológicoRESUMO
Dodecyltrimethylammonium triflate (DTATf) micelles possess lower degree of counterion dissociation (α), lower hydration, and higher packing of monomers than other micelles of similar structure. Addition of sodium triflate ([NaTf] > 0.05 M) to DTATf solutions promotes phase separation. This phenomenon is commonly observed in oppositely charged surfactant mixtures, but it is rare for ionic surfactants and relatively simple counterions. While the properties of DTATf have already been reported, the driving forces for the observed phase separation with added salt remain unclear. Thus, we propose an interpretation for the observed phase separation in cationic surfactant solutions. Addition of up to 0.03 M NaTf to micellar DTATf solutions led to a limited increase of the aggregation number, to interface dehydration, and to a progressive decrease in α. The viscosity of DTATf solutions of higher concentration ([DTATf] ≥ 0.06 M) reached a maximum with increasing [NaTf], though the aggregation number slightly increased, and no shape change occurred. We hypothesize that this maximum results from a decrease in interaggregate repulsion, as a consequence of increased ion binding. This reduction in micellar repulsion without simultaneous infinite micellar growth is, probably, the major driving force for phase separation at higher [NaTf].
RESUMO
A Síndrome dolorosa regional complexa (SDRC) tipo I é um quadro de dor neuropática, que afeta, sobretudo as extremidades dos membros após evento traumático e/ou período de imobilização, na ausência de lesão nervosa. Para além da dor, as características clínicas incluem alterações vasomotoras regionais e freqüentemente limitação da mobilidade da extremidade envolvida. Não está totalmente esclarecida a sua causa e existem poucos consensos em relação ao tratamento ideal. A caixa de espelhos é uma modalidade terapêutica baseada no feedback visual, como forma de construção de uma nova imagem mental do membro afetado, promovendo a reorganização cortical. Esta técnica tem sido utilizada na recuperação motora ou no controlo da dor em situações como o acidente vascular cerebral e o SDRC tipo I.
Complex regional pain syndrome (CRPS) type I is a neuropathic pain condition, commonly affecting a limb extremity after a traumatic event and/or a period of immobilization, in the absence of nerve injury. Besides pain, the clinical features include regional vasomotor alterations and usually a decreased range of motion in the affected extremity. Its actual cause remains somewhat obscure and there are few agreements on optimal treatment. The mirror box is a therapeutic approach based on visual feedback as a way to achieve a new mental imagery of the affected limb by promoting cortical reorganization. This approach has been used for the motor recovery or pain relief in conditions such as stroke or type-I CRPS.