RESUMO
Background: There are limited data on non-oncological high-impact chronic pain (HICP) in Ecuador; we report the epidemiological characteristics of HICP. Materials & methods: In this cross-sectional study, we included a random sample of adult individuals who had cell phones. Results & conclusion: The weighted prevalence of HICP was 9.0%: 12.3% for women and 5.6% for men (p = 0.001). HICP was more frequently localized in the lower back and affected the economically active population. Nonsteroidal anti-inflammatory drugs were more commonly used; however, 61% of patients indicated that the effectiveness of their management was low. Overall, HICP had a negative impact on daily life activities. The effectiveness of the current treatment was low and should include an integrated approach.
We report the frequency, characteristics and associated factors of non-cancer high-impact chronic pain (HICP) in Ecuador. HICP refers to pain that has been felt constantly in the last 3 months. Women were more often affected, and the pain was more commonly localized in the lower back. Most patients indicated that their pain treatment was poor. HICP was common and had a negative impact on daily life activities. The current treatment of HICP must consider the physical and mental aspects of the people who suffer from it; this requires a combination of treatments such as drugs, exercise, physical rehabilitation and mindbody interventions.
Assuntos
Dor Crônica , Adulto , Masculino , Humanos , Feminino , Dor Crônica/epidemiologia , Estudos Transversais , Equador/epidemiologia , Anti-Inflamatórios não Esteroides , Projetos de PesquisaRESUMO
Resumen La neurolinfomatosis (NL) es una condición poco frecuente que se caracteriza por la invasión de células B en los nervios craneales y las raíces nerviosas periféricas y generalmente está vinculada con leucemia o linfoma no Hodking (LNH). En el presente reporte se destacará la importancia de la sospecha diagnóstica en este grupo de pacientes y la importancia de 18F-FDG PET/CT en el diagnóstico diferencial con otras entidades causantes de síntomas similares. Se presenta el caso de una mujer de 63 años con diagnóstico de linfoma difuso de células B grandes, quien, en el tercer ciclo de quimioterapia DA-EPOCH-R, refiere dolor de tipo neuropático en miembro superior derecho, progresivo en severidad y en extensión con compromiso de la extremidad contralateral, convulsiones y parálisis facial periférica.
Abstract Neurolinfomatosis (LN) is a strange condition, defined as Invasion of cranial nerves and peripheral nerve roots by leukemia or lymphoma. Most of the cases are caused by non-Hodgkin's lymphoma of B cells (BHL). The present paper aims to emphasize the importance of suspecting this entity in patients with NHL and neuropathic pain and the role of 18F-FDG PET-CT in the diagnosis. We present the case of a 63-year-old woman diagnosed with diffuse large B-cell lymphoma, who in her third chemotherapy session DA-EPOCH-R of neuropathic pain in the right upper limb, with a poor clinical outcome, due to worsening pain, contralateral limb involvement, seizures and peripheral facial paralysis.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Linfoma não Hodgkin , Fluordesoxiglucose F18 , NeurolinfomatoseRESUMO
El dolor crónico constituye un reto terapéutico especial. Se presenta una revisión narrativa sobre el papel del tratamiento de oxigenación hiperbárica (TOHB) en el tratamiento del dolor neuropático, y sus aplicaciones en dolor crónico, síndromes neurosensitivos disfuncionales y oncodolor. El conocimiento de las indicaciones de TOHB en algiología y su aplicación en la práctica médica puede contribuir a mejorar la calidad de vida del paciente. (AU)
Chronic pain represents a special therapeutic challenge. We present a narrative review on the role of Hyperbaric Oxygen Therapy (HBOT) in the treatment of neuropathic pain, and its applications in chronic pain, dysfunctional neurosensitive syndromes and oncological pain. The knowledge of the indications of HBOT in algiology and its application in medical practice can contribute to improve the quality of life of the patient. (AU)
Assuntos
Dor Crônica/terapia , Oxigenoterapia Hiperbárica/métodos , Membro Fantasma/terapia , Qualidade de Vida , Distrofia Simpática Reflexa/terapia , Cefaleias Vasculares/terapia , Encefalopatias/terapia , Dor Facial/terapia , Fibromialgia/terapia , Causalgia/terapia , Neuropatias Diabéticas/terapia , Edema/terapia , Neuralgia Pós-Herpética/terapia , Dor Crônica/epidemiologia , Dor do Câncer/terapia , Oxigenoterapia Hiperbárica/tendências , Analgesia/métodos , Inflamação/terapia , Neuralgia/terapiaRESUMO
Actualmente los opioides son el soporte del manejo farmacológico, en particular del dolor moderado a severo. En este sentido, es importante disponer de distintas formulaciones y vías de administración, aún más en el contexto del paciente oncológico. La buprenorfina tiene un bajo peso molecular, de alta potencia y liposolubilidad combinada a una favorable tolerabilidad y un bajo potencial de abuso. Por dichas razones la buprenorfina es ideal para aplicación transdérmica. La evidencia clínica disponible demuestra eficacia y seguridad en el empleo de la buprenorfina transdérmica en el tratamiento de dolor de moderado a severo en el paciente oncológico. Sin embargo, la buprenorfina no ha sido extensamente estudiada en ciertas poblaciones como otros opioides y se requieren nuevas investigaciones para definir el rol de esta en circunstancias clínicas específicas.
Opiods are the current pharmalogical remedies of choice for the control of moderate to severe pain. Subsequently, it is important to rely on a number of prescriptions and applications for these drugs, particularly in the case of oncological patients. Low molecular weight, high potency and liposolubility of buprenorphine combine with its favorable tolerance and low abuse probability. Clinical evidence reveals that the use of transdermal buprenorphine in the treatment of moderate to severe pain in oncological patients is effective and safe. However, buprenorphine has not been widely studied among certain populations, as have other opiods, thus making further research necessary in order to define its role under specific clinical circumstances.
Assuntos
Humanos , Analgésicos Opioides , Buprenorfina , Vias de Administração de Medicamentos , Dor/patologia , Neoplasias/patologia , Preparações Farmacêuticas , ColômbiaRESUMO
O tratamento não farmacológico da dor do câncer ainda é pouco explorado e utilizado na área da saúde. A falta de maior fundamentação científica para a utilização dos recursos fisioterapêuticos, e mesmo o desconhecimento da existência desses recursos dificulta sua implementação como instrumento para o tratamento da dor oncológica. Entretanto, esses recursos não invasivos podem, em muito, beneficiar os pacientes que sofrem com a dor do câncer.O objetivo deste estudo foi realizar uma revisão da literatura sobre o assunto, com o propósito de conhecer melhor alguns dos recursos fisioterapêuticos no controle da dor oncológica. Os recursos mais citados como coadjuvantes no controle desse tipo de dor são estimulação elétrica nervosa transcutânea (TENS), termoterapia, crioterapia, massagem terapêutica e cinesioterapia, além da orientação específica aos pacientes, cuidadores e familiares. A associação dos recursos fisioterapêuticos com o tratamento farmacológico pode ser de grande valia para o paciente com dor oncológica. Essa associação pode ajudar na redução da medicação analgésica e, consequentemente, minimizar os efeitos colaterais causados pela medicação de longo prazo. No entanto, os resultados da revisão da literatura demonstraram que os estudos desenvolvidos, até agora, não oferecem evidências suficientes para recomendar ou rejeitar a utilização dos recursos citados para o controle da dor do paciente com câncer. Estudos mais controlados e metodologias adequadas são necessários para que a fisioterapia possa desenvolver sua prática baseada em evidência.
The non-pharmacological treatment of cancer pain has been little explored and yet little used. Lack of a scientificsupport for the use of physiotherapeutic resources and, in some cases, the ignorance about the existence of suchresources has hindered their implementation as effective tools for the treatment of cancer pain. However, these non invasive methods can be of great help to patients suffering from cancer pain. This study aims at reviewing the literature on the subject in search of more information about some physiotherapeutic resources to the treatment of oncological pain. The most common resources recommended for the treatment of cancer pain are: transcutaneous electric nerve stimulation (TENS), thermotherapy, cryotheraphy, therapeutic massage and therapeutic exercise together with specific guidelines offered to patients, caretakers and families. Cancer patients can greatly benefit from the association of physiotherapeutic resources with the pharmacological treatment. This association can help reduce the use of analgesic medication, thus minimizing the side effects caused by long term medication. However, the results of this review of the literature demonstrate that the studies on the subject developed so far are not enough to recommend or reject the use of those resources for the treatment of oncological pain. The issue demands more research and appropriate methodology to allow physical therapy to better develop its evidencebasedpractice.