Ponencia invitada en la V Jornada de Fisioterapia en Geriatría, Barcelona 2015.
"Pain management in the elderly". Invited speaker at V Jornada de Fisioterapia en Geriatría, Barcelona 2015.
Breve exposición teórica sobre radiculopatías y dolor radicular, que forma parte del taller compartido con Arturo Such en el III Congreso de Estudiantes de Fisioterapia de la Universidad San Jorge (Zaragoza)
The professor David Lopez, PT and DC expose about the theorical basis of manual therapy in Osteopathy for extremities. In a short approach inted demonstrate the differences and similarities with other manual therapy concepts
In this presentation the author, David Lopez Chiropractor DC and Kinesiologyst (PT) from Chile expose about the different principles under the scope of the osteopathic manipulation of the spine. Dr. Lopez is director of the progran in Chiropractic for healh professional of the "Universidad Central de Chile" and director of the Diplomats in Manual Therapy of the "Universidad Santo Tomas de Chile. The interest is to review the fundamentals to understand the approach of the Osteopathy to the practice of the manual therapy and healthcare. This vision was exposed in Poland in the framework of an international symposium of Physiotherapy.
Breve exposición teórica sobre radiculopatías y dolor radicular, que forma parte del taller compartido con Arturo Such en el III Congreso de Estudiantes de Fisioterapia de la Universidad San Jorge (Zaragoza)
The professor David Lopez, PT and DC expose about the theorical basis of manual therapy in Osteopathy for extremities. In a short approach inted demonstrate the differences and similarities with other manual therapy concepts
In this presentation the author, David Lopez Chiropractor DC and Kinesiologyst (PT) from Chile expose about the different principles under the scope of the osteopathic manipulation of the spine. Dr. Lopez is director of the progran in Chiropractic for healh professional of the "Universidad Central de Chile" and director of the Diplomats in Manual Therapy of the "Universidad Santo Tomas de Chile. The interest is to review the fundamentals to understand the approach of the Osteopathy to the practice of the manual therapy and healthcare. This vision was exposed in Poland in the framework of an international symposium of Physiotherapy.
Abstract
A total of 50 procedures were performed, 25 patients were treated using SpineView decompressor and 25 patients by Nucleoplasty using the Arthrocare Coblation technology. The total population had leg pain (sciatica), 30 of which had low back pain (discogenic pain) . Mean age of patients was 30 – 60 years. The mean follow-up period was 1 year. Follow up was done weekly for the first 2 months then monthly for the first year post-procedure according to Visual Analogue Scale , Urs Muller et.al.(2008) as well as featured neurological examination.
Analgesic consumption was stopped or reduced in 9 of the 15 patients with sciatica and low back pain treated with SpineView decompressor (60%) at 2 months (66%) 4months after the procedure, and in 9 of the 15 patients with sciatica and low back pain treated by Nucleoplasty using the Arthrocare Coblation technology (60%) at 2 months (66%) 4months after the procedure.
The patients who had sciatica only has shown reduction in analgesic consumption in 9 of the 10 patients who were treated with SpineView decompressor (90%) at 2 months, and in 2 of the 10 patients who were treated by Nucleoplasty using the Arthrocare Coblation technology (20%) at 2 months.
Our results encourage us to use SpineView decompressor in carefully selected patients with sciatica and small contained disc protrusion . Also we find that applying Nucleoplasty using the Arthrocare Coblation technology in those patients with low back pain and small contained disc protrusion can give satisfactory results. These results need further efforts and researches in order to be general recommendations.
Was recently asked to discuss whether there is evidence to support the use of B vitamins in managing different aches and pains. Here's my talk delivered last 16 Sept 2016 at the 12th Post Graduate Course of the East Avenue Medical Center Department of Internal Medicine.
Abstract
A total of 50 procedures were performed, 25 patients were treated using SpineView decompressor and 25 patients by Nucleoplasty using the Arthrocare Coblation technology. The total population had leg pain (sciatica), 30 of which had low back pain (discogenic pain) . Mean age of patients was 30 – 60 years. The mean follow-up period was 1 year. Follow up was done weekly for the first 2 months then monthly for the first year post-procedure according to Visual Analogue Scale , Urs Muller et.al.(2008) as well as featured neurological examination.
Analgesic consumption was stopped or reduced in 9 of the 15 patients with sciatica and low back pain treated with SpineView decompressor (60%) at 2 months (66%) 4months after the procedure, and in 9 of the 15 patients with sciatica and low back pain treated by Nucleoplasty using the Arthrocare Coblation technology (60%) at 2 months (66%) 4months after the procedure.
The patients who had sciatica only has shown reduction in analgesic consumption in 9 of the 10 patients who were treated with SpineView decompressor (90%) at 2 months, and in 2 of the 10 patients who were treated by Nucleoplasty using the Arthrocare Coblation technology (20%) at 2 months.
Our results encourage us to use SpineView decompressor in carefully selected patients with sciatica and small contained disc protrusion . Also we find that applying Nucleoplasty using the Arthrocare Coblation technology in those patients with low back pain and small contained disc protrusion can give satisfactory results. These results need further efforts and researches in order to be general recommendations.
Was recently asked to discuss whether there is evidence to support the use of B vitamins in managing different aches and pains. Here's my talk delivered last 16 Sept 2016 at the 12th Post Graduate Course of the East Avenue Medical Center Department of Internal Medicine.
Simposio Técnico “Las otras caras de la Enfermedad de Alzheimer”. Organizado por Comunidad de Madrid y Fundación Reina Sofía Alzheimer. Madrid (Junio 2015).
Conference talk given to the II Congreso Internacional del Colegio Oficial de Fisioterapeutas de Canarias, called: Neurodynamic and neuropathic pain.
Neuropathic pain is defined as pain initiated or caused by a primary lesion or dysfunction in the nervous system (Treede et al., 2008). Evidence-based recommendations
for pharmacologic and non-pharmacological treatment have been published. Regarding non-pharmacological treatments, physical therapy has been suggested. Among all the modalities concerning physical therapy, this presentation is focused on neural mobilization (or neurodynamics).
----------------------
Esta presentación forma parte de la ponencia que dí en el II Congreso Internacional del Colegio Oficial de Fisioterapeutas de Canarias, titulada: Neurodinámica y dolor neuropático.
El dolor neuropático es aquel que aparece como consecuencia directa de una lesión o enfermedad que afecta al sistema somatosensorial (Treede et al., 2008).
En cuanto a las posibilidades terapéuticas del dolor neuropático, incluye tanto un tratamiento farmacológico como no farmacológico. Dentro de las alternativas no farmacológicas, encontramos la fisioterapia y de todas las intervenciones posibles, esta presentación se centra en la neurodinámica.
Descripción del curso de Punción Seca en paciente neurológico DHNS®
La técnica DNHS® (Dry Needling for Hypertonia and Spasticity) es una técnica de punción seca cuyo objetivo es disminuir la espasticidad e hipertonía del paciente con lesión del sistema nervioso central y mejorar su funcionalidad. Actualmente encuadrada en la Línea de Investigación en Biomecánica y Análisis del Movimiento de la Universidad San Jorge y más concretamente dentro de la Línea de Investigación DNHS.
Las técnicas de punción seca vienen siendo utilizadas desde hace años tanto en España como en otros países por fisioterapeutas especializados en el tratamiento del dolor miofascial. La punción seca ha demostrado en el caso del tratamiento del dolor miofascial ser una técnica igual de efectiva que la infiltración de sustancias como la toxina botulínica, con la ventaja de no tener efectos secundarios. Así lo demuestran diversos estudios.
Objetivos del curso de Punción Seca en paciente neurológico DHNS®
Objetivos del curso
Lograr que aquellos fisioterapeutas que trabajan con pacientes neurológicos y que no tengan formación previa en punción seca, puedan recibir una formación básica sobre esta técnica orientada al tratamiento de la hipertonía y la espasticidad. En el curso se aborda además de todos los aspectos teóricos sobre la técnica DNHS® el tratamiento mediante punción de los músculos que habitualmente más interfieren en los patrones correctos de movimiento.
Comprender la naturaleza, características clínicas y fisiopatología de los puntos gatillo miofasciales (PGM), así como sus relaciones con el sistema nervioso central (SNC).
Conocer los fundamentos de la punción seca y su aplicación en el tratamiento del dolor miofascial.
Conocer los fundamentos neurofisiológicos del método y técnica DNHS así como la aplicación clínica en pacientes con lesión del SNC que cursan con hipertonía y espasticidad y otras alteraciones del movimiento.
Conocer las diferencias de criterio diagnóstico y terapéutico de la punción seca para el tratamiento del dolor miofascial respecto al tratamiento de la hipertonía y la espasticidad (DNHS®)
Ser capaz de integrar desde un marco teórico el método DNHS® dentro de la práctica clínica como complemento de otros tratamientos.
Saber aplicar la técnica DNHS® en los músculos explicados durante el curso.
Aplicaciones de la técnica DNHS®
La técnica DNHS® utiliza para su aplicación agujas de punción seca, similares a las de acupuntura, (filiformes, macizas y de punta cónica, no biselada) sin introducir ningún tipo de sustancia en el cuerpo. La estructura diana de la técnica DNHS® es el punto gatillo miofascial, más concretamente las placas motoras disfuncionales responsables de la contracción mantenida de las sarcómeras.
Esta técnica se viene aplicando en diferentes Centros Sanitarios desde 2007 como parte del tratamiento de fisioterapia que se ofre
Esercizio fisico e diabete. Studio della funzione neuromuscolare (bibliografia)
Marco Infusino, Eugenio Maria Pistone
http://www.calzetti-mariucci.it/shop/prodotti/strength-conditioning-n-7
10 TESIS PENGARUH UMUR, DEPRESI DAN DEMENSIA TERHADAP DISABILITAS FUNGSIONAL ...Bondan Palestin
Kelompok lansia dipandang sebagai kelompok masyarakat yang berisiko (population at risk) mengalami gangguan kesehatan. Oleh karenanya, kelompok lansia merupakan kelompok risiko tinggi yang menjadi perhatian utama dalam cabang ilmu keperawatan komunitas. Masalah keperawatan yang menonjol pada kelompok tersebut adalah meningkatnya disabilitas fungsional fisik sebagai dampak dari respon lansia terhadap proses penuaan, penyakit kronis, atau status psikososialnya. Disabilitas fungsional lansia sebagai efek dari perubahan fisiologis (umur depresi dan demensia) memungkinkan untuk dijelaskan melalui Model Sistem Neuman (MSN). Mengingat MSN memiliki banyak interrelasi konsep sehingga derivasi teori konseptual tersebut lebih bersifat kontekstual. Oleh karenanya, peneliti bermaksud agar penelitian ini dapat digunakan sebagai studi pendahuluan terhadap penelitian-penelitian mengenai disabilitas fungsional yang lebih kompleks. Gigliotti (2003) berpendapat bahwa kredibilitas MSN hanya dapat dikembangkan melalui proses derivasi dan pengujian teori antara (middle-range theory) sebagai derivat dari MSN.
Chronic pain is common. If we don’t suffer from it ourselves, chances are we know someone who does. Changes in the structure and function of the brain are thought to underlie chronic pain. The good news is that these changes are not hardwired. Many things can be done to influence how the brain processes pain signals including exercise, healthy eating, and better sleep, as well as thinking more adaptive thoughts, positive emotions, and feeling love and connected. This session will highlight the neuroscience related to chronic pain and how engaging in simple self-management strategies can result in less pain and a more rewarding life.
This presentation comes from the Spring Patient Education conference presented by the Scleroderma Patient Education Conference presented by the Scleroderma Foundation of Greater Chicago.
Chronic pain is common. If we don’t suffer from it ourselves, chances are we know someone who does. Changes in the structure and function of the brain are thought to underlie chronic pain. The good news is that these changes are not hardwired. Many things can be done to influence how the brain processes pain signals including exercise, healthy eating, and better sleep, as well as thinking more adaptive thoughts, positive emotions, and feeling love and connected. This session will highlight the neuroscience related to chronic pain and how engaging in simple self-management strategies can result in less pain and a more rewarding life.
This presentation comes from the Spring Patient Education conference presented by the Scleroderma Patient Education Conference presented by the Scleroderma Foundation of Greater Chicago.
Depression is an insidious issue in the US and elsewhere. Lifestyle habits that are very different from our ancestral environment may be to blame, and one particularly problematic area is food choice. Depressive symptoms share much in common with the adaptive features of sickness behavior, which is functional when operating in an environment of ancestrally normal immune stressor. Modern diets likely activate the immune system (primarily the inflammatory response) and induce the cascade of adaptive responses that collective make up sickness behavior. Due to their similarities, these may then diagnosed as depression. In this talk, I discuss the links among diet, depression, and inflammation, as well as highlighting some specific dietary components that contribute to this response.
Lecture References and online resources: Tendons: Mechanisms of pathogenicity...Mark Sexton
This lecture reviews and connects developments different areas of the published research: in the areas of Anatomy, Cellular Mechanotransduction, Connective Tissue (Histology, Innervation, differentiation, plasticity), Tendinopathy, Tendon Repair, Neural plasticity and Bioplasticity.
These developments have implications for clinical practice, research, education and health promotion.
This research was discussed as it informs common Treatment and Rehabilitation techniques (Exercise Therapy, Acupuncture, Manual Therapy, Low Level Laser, Biomechanics). Future directions in research were discussed.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
3. 73.5%
Miró, J., Paredes, S., Rull, M., Queral, R., Miralles, R., Nieto, R., … & Baos, J. (2007). Pain in older adults: A prevalence study in the Mediterranean region of Catalonia.
European Journal of Pain, 11: 83. doi: 10.1016/j.ejpain.2006.01.001
DOLOR
CRÓNICO
94.5%
4. Bonifazi, W.L. (2000). Painful truths. Contemporary Long Term Care, 23(8), 1
No se diagnostica
No se trata
Se confunde con
demencia o depresión
Frecuentemente, el dolor…
6. Mielinizadas: 35%
No mielinizadas: 50%
[Neurotransmisores]
Transporte axonal
AFERENTES NOCICEPTIVAS PRIMARIAS
Verdu E, Ceballos D, Vilches JJ, et al. Influence of aging on peripheral nerve function and regeneration. J Peripher Nerv Syst. 2000;5:191–208.
Ochoa J, Mair WGP. The normal sural nerve in man. II. Changes in the axon and schwann cells due to ageing. Acta Neuropathol (Berl). 1969; 13:217–239.
O’Sullivan DJ, Swallow M. The fibre size and content of the radial and sural nerves. J Neurol Neurosurg Psychiatry. 1968;31:464–470.
Rafalowska J, Drac H, Roeinska K. Histological and electrophysiological changes of the lower motor neuron with aging. Polish Medical Science and Histology Bulletin.
1976;15:271–280
7. SISTEMA NERVIOSO CENTRAL
Muerte
neuronal
Pérdida de las
ramificaciones
dendríticas
Cambios
neuroquímicos
Pérdida de
mielina
Deterioro
sistema
inhibidor endógeno
del dolor
Prineas JW, Spencer PS. Pathology of the nerve cell body in disorders of the peripheral nervous system. In: Dyck PJ, Thomas PK, Lambert EH, eds. Peripheral Neuropathy.
Philadelphia: W B Saunders; 1975:253–295.
Ko ML, King MA, Gordon TL, et al. The effects of aging on spinal neurochemistry in the rat. Brain Res Bull. 1997;42:95–98.
Hamm RJ, Knisely JS. Environmentally-induced analgesia: an agerelated decline in a neurally-mediated, nonopioid system. Psychol Aging. 1986;1:195–201.
Bodnar RJ, Romero MT, Kramer E. Organismic variables and pain inhibition: roles of gender and aging. Brain Res Bull. 1988;21:947–953.
8. UMBRALES DE DOLOR
Umbral
estímulos térmicos
Umbral
dolor a la presión
Lautenbacher, S., Kunz, M., Strate, P., Nielsen, J., & Arendt-Nielsen, L. (2005). Age effects on pain thresholds, temporal summation and spatial summation of heat and
pressure pain. Pain, 115(3), 410–8. doi:10.1016/j.pain.2005.03.025
Tolerancia
Al dolor
9. DETERIORO COGNITIVO
Respuesta a
estímulos limitada
Expresividad facial
Conductas de dolor
Scherder E, Bouma A, Borkent M, Rahman O. Alzheimer patients report less pain intensity and pain affect than non-demented elderly. Psychiatry [Internet].
1999;62(3):265–72
Scherder E J, Sergeant J A, Swaab D F et al. Pain processing in dementia and its relation to neuropathology. Lancet Neurology 2003; 2:677–686
11. DOLOR
AGUDO
Gibson, S. J., & Helme, R. D. (2001). Age-related differences in pain perception and report. Clinics in Geriatric Medicine, 17(3), 433 456.
Tresch, D. D. (1998). Management of the older patient with acute myocardial infarction: difference in clinical presentations between older
and younger patients. Journal of the American Geriatrics Society, 46,1157 1162.
Enfermedades
que cursan
con dolor
Confusión
Agitación
Agresividad
Anorexia
Fatiga
¿Dolor?
12. DOLOR
AGUDO
Cole, L. J., Farrell, M. J., Gibson, S. J., & Egan, G. F. (2010). Age-related differences in pain sensitivity and regional brain activity evoked by
noxious pressure. Neurobiology of Aging, 31(3), 494 503
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