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De Rojas D.H.F.,IIS Hospital la Fe | Ibanez E.,IIS Hospital la Fe | Longhurst H.,Barts Health NHS Trust | Maurer M.,Charite - Medical University of Berlin | And 5 more authors.
International Archives of Allergy and Immunology | Year: 2015

Background: Icatibant, a selective bradykinin B2 receptor antagonist for the treatment of acute hereditary angio-oedema (HAE) attacks in adults, can be administered by health care professionals (HCPs) or self-administered. This analysis compared characteristics and outcomes of acute HAE attacks treated with self-administered and HCP-administered icatibant in a real-world setting. Methods: The Icatibant Outcome Survey (Shire, Zug, Switzerland; NCT01034969) is an international observational study monitoring the safety and effectiveness of icatibant treatment. Descriptive retrospective analyses were performed (February 2008 to December 2012). Results: Icatibant was used in 652 attacks in 170 patients with HAE type I/II. Most icatibant injections were self-administered (431/652, 68.5%). The proportion of self-treated attacks increased over time (40.3% in 2009 vs. 89.7% in 2012). The median time to administration was significantly shorter in self-versus HCP-treated attacks (1.5 vs. 2.4 h; p = 0.016). Earlier treatment (<2 h after onset) was significantly associated with a shorter median time to resolution (2.5 vs. 5.0 h; p = 0.032) and attack duration (3.0 vs. 14.0 h; p < 0.0001), regardless of administration method. Patients self-administered icatibant for attacks of all severities; overall, 34.7% of severe and 30.2% of very severe attacks were HCP treated. Logistic regression analysis did not find use of long-term prophylaxis, attack location or gender to be predictive for self-administration. Conclusions: The proportion of HAE attacks treated with self-administered icatibant increased over time. Patients successfully self-administered icatibant for a wide variety of HAE attacks, demonstrating that icatibant is generally well tolerated and effective for self-administration. Self-administration of icatibant provides a complementary option to HCP administration, enabling optimization of patient care. © 2015 S. Karger AG, Basel. Source

Martin-Pintado-Zugasti A.,University of San Pablo - CEU | Pecos-Martin D.,University of Alcala | Rodriguez-Fernandez T.L.,University of San Pablo - CEU | Alguacil-Diego I.M.,Rey Juan Carlos University | And 4 more authors.
PM and R | Year: 2015

Objective: To investigate the effect of ischemic compression (IC) versus placebo and control on reducing postneedling soreness of 1 latent myofascial trigger point and on improving cervical range of motion (CROM) in asymptomatic subjects. Design: A randomized, double-blind, placebo-controlled trial with 72-hour follow-up. Setting: A university community. Participants: Asymptomatic volunteers (N = 90: 40 men and 50 women) aged 18 to 39 years (mean ± standard deviation [SD]: 22 ± 3 years). Intervention: All subjects received a dry needling application over the upper trapezius muscle. Participants were then randomly divided into 3 groups: a treatment group who received IC over the needled trapezius muscle, a placebo group who received sham IC, and a control group who did not receive any treatment after needling. Main Outcome Measures: Visual analog scale (VAS; during needling, at posttreatment and 6, 12, 24, 48, and 72 hours) and CROM (at preneedling, postneedling, and 24 and 72 hours). Results: Subjects in the IC group showed significantly lower postneedling soreness than the placebo and the control group subjects immediately after treatment (mean ± standard deviation [SD]: IC, 20.1 ± 4.8; placebo, 36.7 ± 4.8; control, 34.8 ± 3.6) and at 48 hours (mean ± SD: IC, 0.6 ± 1; placebo, 4.8 ± 1; control, 3.8 ± 0.7). In addition, subjects in the dry needling+IC group showed significantly lower postneedling soreness duration (. P = .026). All subjects significantly improved CROM in contralateral lateroflexion and both homolateral and contralateral rotations, but only the improvements found in the IC group reached the minimal detectable change. Conclusions: IC can potentially be added immediately after dry needling of myofascial trigger point in the upper trapezius muscle because it has the effect of reducing postneedling soreness intensity and duration. The combination of dry needling and IC seems to improve CROM in homolateral and contralateral cervical rotation movements. © 2015 American Academy of Physical Medicine and Rehabilitation. Source

De-La-Torre-Domingo C.,Alfonso X El Sabio University | Alguacil-Diego I.M.,Rey Juan Carlos University | Molina-Rueda F.,Rey Juan Carlos University | Lopez-Roman A.,Alfonso X El Sabio University | And 2 more authors.
Archives of Physical Medicine and Rehabilitation | Year: 2015

Objective To examine the immediate and prolonged effects (7d) of Kinesiology Tape (KT) on balance in subjects with chronic ankle instability using computerized dynamic posturography (CDP). Design A 7-day follow-up, single-blind randomized controlled trial. Setting University community. Participants Subjects (N=36) were screened for possible eligibility criteria, and 30 successfully completed the study protocol. Of these, 15 were randomly assigned to the experimental group (KT: 5 men, 10 women), and 15 were assigned to the control group (placebo tape: 10 men, 5 women). Interventions The experimental group was taped for a lateral ankle sprain with KT. In the control group, a placebo tape was used. Balance was assessed under the following 3 conditions: without taping, immediately after application, and after 7 days of use. Main Outcome Measures The CDP device used in this study was the Smart Equitest version 8.2. CDP analysis was conducted using the Sensory Organization Test (SOT). As primaries outcome measures, the composite SOT score and composite SOT strategy were chosen. The partial score for SOT condition 2 and its strategy were considered as the secondary outcomes measures. Results Repeated-measures analysis of variance (ANOVA) demonstrated that there was not a significant interaction between group and time in the composite SOT score (F=.239; P=.73), SOT condition 2 (F=.333; P=.705), and SOT strategy 2 (F=.899; P=.43). Additionally, repeated-measures ANOVA showed a significant effect for time (composite SOT score: F=40.69; P≤ SOT condition 2: F=4.61; P=.014; SOT strategy 2: F=.899; P=.413; composite SOT strategy: F=15.14; P≤;.01). Specifically, post hoc analysis showed that both groups obtained improvements in composite SOT scores immediately after tape application and 7 days of use. Conclusions According to our results, the SOT scores of both the KT and control groups improved during follow-up. No differences between them were observed during the follow-up in most balance measurements. The observed changes may be related to a subjective increase in confidence after the tape application. © 2015 American Congress of Rehabilitation Medicine. Source

Martin-Pintado-Zugasti A.,University of San Pablo - CEU | Rodriguez-Fernandez A.L.,University of San Pablo - CEU | Fernandez-Carnero J.,Rey Juan Carlos University | Fernandez-Carnero J.,Hospital la Paz Institute for Health Research
Journal of Back and Musculoskeletal Rehabilitation | Year: 2016

BACKGROUND: Postneedling soreness is considered the most frequent secondary effect associated to dry needling. A detailed description of postneedling soreness characteristics has not been previously reported. OBJECTIVE: (1) to assess the intensity and duration of postneedling soreness and tenderness after deep dry needling of a trapezius latent myofascial trigger point (MTrP), (2) to evaluate the possible differences in postneedling soreness between sexes and (3) to analyze the influence on postneedling soreness of factors involved in the dry needling process. METHODS: Sixty healthy subjects (30 men, 30 women) with latent MTrPs in the upper trapezius muscle received a dry needling intervention in the MTrP. Pain and pressure pain threshold (PPT) were assessed during a 72 hours follow-up period. RESULTS: Repeated measures analysis of covariance showed a significant effect for time in pain and in PPT. An interaction between sex and time in pain was obtained: women exhibited higher intensity in postneedling pain than men. The pain during needling and the number of needle insertions significantly correlated with postneedling soreness. CONCLUSIONS: Soreness and hyperalgesia are present in all subjects after dry needling of a latent MTrP in the upper trapezius muscle. Women exhibited higher intensity of postneedling soreness than men. © 2016 - IOS Press and the authors. All rights reserved. Source

La Touche R.,Autonomous University of Madrid | La Touche R.,Institute of Neuroscience and Craniofacial Pain INDCRAN | La Touche R.,Hospital la Paz Institute for Health Research | Paris-Alemany A.,Autonomous University of Madrid | And 14 more authors.
Journal of Headache and Pain | Year: 2015

Methods: An experimental case–control study investigated 83 patients with headache attributed to TMD and 39 healthy controls. Patients were grouped according to their scores on the neck disability index (NDI) (mild and moderate neck disability). Initial assessment included the pain catastrophizing scale and the Headache Impact Test-6. The protocol consisted of baseline measurements of pressure pain thresholds (PPT) and pain-free maximum mouth opening (MMO). Individuals were asked to perform the provocation chewing test, and measurements were taken immediately after and 24 hours later. During the test, patients were assessed for subjective feelings of fatigue (VAFS) and pain intensity.Background: Recent research has shown a relationship of craniomandibular disability with neck-pain-related disability has been shown. However, there is still insufficient information demonstrating the influence of neck pain and disability in the sensory-motor activity in patients with headache attributed to temporomandibular disorders (TMD). The purpose of this study was to investigate the influence of neck-pain-related disability on masticatory sensory-motor variables.Results: VAFS was higher at 6 minutes (mean 51.7; 95% CI: 50.15-53.26) and 24 hours after (21.08; 95% CI: 18.6-23.5) for the group showing moderate neck disability compared with the mild neck disability group (6 minutes, 44.16; 95% CI 42.65-45.67/ 24 hours after, 14.3; 95% CI: 11.9-16.7) and the control group. The analysis shows a decrease in the pain-free MMO only in the group of moderate disability 24 hours after the test. PPTs of the trigeminal region decreased immediately in all groups, whereas at 24 hours, a decrease was observed in only the groups of patients. PPTs of the cervical region decreased in only the group with moderate neck disability 24 hours after the test. The strongest negative correlation was found between pain-free MMO immediately after the test and NDI in both the mild (r = −0.49) and moderate (r = −0.54) neck disability groups. VAFS was predicted by catastrophizing, explaining 17% of the variance in the moderate neck disability group and 12% in the mild neck disability group.Conclusion: Neck-pain-related disability and pain catastrophizing have an influence on the sensory-motor variables evaluated in patients with headache attributed to TMD. © 2015, La Touche et al.; licensee Springer. Source

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