#31
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Ðàäèî÷àñòîòíàÿ òåðàïèÿ
Îäíî èññëåäîâàíèå (Sollitto è ñîàâòîðû [36]) ïîä ÓÇÈ êîíòðîëåì âûïîëíÿëè ðàäèî÷àñòîòíóþ êîàãóëÿöèþ îáëàñòè ïðèêðåïëåíèÿ ïëàíòàðíîé ôàñöèè ê ïÿòî÷íîé êîñòè ó 39 ïàöèåíòîâ. Ó 92% ïàöèåíòîâ áîëü ïîëíîñòüþ ïðîøëà. Îäíàêî, ó áîëüøèíñòâà ïàöèåíòîâ èç íàáëþäåíèÿ Sollitto è ñîàâòîðîâ áîëè äëèëèñü âñåãî-ëèøü 2-3 ìåñÿöà è èõ íåëüçÿ áûëî ðàññìàòðèâàòü êàê ñëó÷àè óïîðíîãî ïëàíòàðíîãî ôàñöèèòà. Ñêîðåå âñåãî ó ýòèõ ïàöèåíòîâ ìîæíî áûëî äîáèòüñÿ óñïåõà ìåíåå èíâàçèâíûìè ìåòîäàìè. Êðîìå òîãî, â èññëåäîâàíèè îòñóòñòâîâàëà ãðóïïà êîíòðîëÿ. Ðåêîìåíäàöèÿ. Èíâàçèâíûé õàðàêòåð ïðîöåäóðû è ìàëîå êîëè÷åñòâî äîêàçàòåëüñòâ â íàñòîÿùåå âðåìÿ íå ïîçâîëÿþò ðåêîìåíäîâàòü ðàäèî÷àñòîòíóþ òåðàïèþ äëÿ ëå÷åíèÿ ïëàíòàðíîãî ôàñöèèòà. |
#32
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Ìàãíèòíûå ñòåëüêè
Åñòü ÐÊÈ [] , îñíîâíîé âûâîä êîòîðîãî – íåýôôåêòèâíî. Ïåðåâîäèòü, ê ñîæàëåíèþ, íåêîãäà. JAMA september 2003 vol 290 n 11 |
#33
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Õèðóðãè÷åñêèå ìåòîäû ëå÷åíèÿ
Õèðóðãè÷åñêèå ìåòîäû ëå÷åíèÿ öåëåñîîáðàçíî ðàññìàòðèâàòü òîëüêî ïðè íåýôôåêòèâíîñòè êîíñåðâàòèâíîé òåðàïèè ïðîäîëæèòåëüíîñòüþ ñâûøå 12 ìåñÿöåâ. Âî ìíîãèõ ðóêîâîäñòâàõ ãîâîðèòñÿ ïåðèîäå â 6 ìåñÿöåâ, îäíàêî ó ìíîãèõ ïàöèåíòîâ ðàçðåøåíèå ñèìïòîìîâ ìîæåò ïðîèçîéòè â ïðîìåæóòêå ìåæäó 6 è 12 ìåñÿöàìè [19]. Ïëàíòàðíóþ ôàñöèîòîìèþ ÷àñòî ñî÷åòàþò ñ íåâðîëèçîì íåðâà, èäóùåãî ê ìûøöå, îòâîäÿùåé ïÿòûé ïàëåö ñòîïû [37]. Ïî ñðàâíåíèþ ñ òðàäèöèîííûìè, ýíäîñêîïè÷åñêèå îïåðàöèè íå èìåþò ïðåèìóùåñòâ, îäíàêî ïî ýòîìó âîïðîñó âûïîëíÿëèñü òîëüêî ðåòðîñïåêòèâíûå èññëåäîâàíèÿ [38]. Âî ìíîãèõ èññëåäîâàíèÿõ àâòîðû îòìå÷àþò êóïèðîâàíèå ñèìïòîìîâ ïîñëå îïåðàöèè ïî ïîâîäó óïîðíîãî ïëàíòàðíîãî ôàñöèèòà â 70-90% ñëó÷àåâ [37, 38, 39, 40, 41]. Îäíàêî, äîëãîñðî÷íûå ðåçóëüòàòû îïåðàöèé âûãëÿäÿò íå ñòîëü îáíàäåæèâàþùå. Ôàñöèîòîìèÿ ïðèâîäèò ê óïëîùåíèþ ïðîäîëüíîãî ñâîäà ñòîïû è ïðîãðåññèðîâàíèþ ïëîñêîñòîïèÿ, êîòîðîå ñëóæèò èñòî÷íèêîì âòîðè÷íûõ ïðîáëåì [40]. Davies è ñîàâòîðû îáíàðóæèëè, ÷òî íåñìîòðÿ íà õîðîøèå íåïîñðåäñòâåííûå ðåçóëüòàòû, 48% ïàöèåíòîâ áûëè íåóäîâëåòâîðåííû îòäàëåííûìè ðåçóëüòàòàìè õèðóðãè÷åñêîãî ëå÷åíèÿ [39]. Ê àíàëîãè÷íûì ðåçóëüòàòàì ïðèøëè è äðóãèå àâòîðû, îäíàêî â èõ ðàáîòàõ ñîîáùàåòñÿ î 30-35% íåóäîâëåòâîðèòåëüíûõ îòäàëåííûõ ðåçóëüòàòîâ [37, 41, 42]. Ðåêîìåíäàöèÿ Õèðóðãè÷åñêîå ëå÷åíèå ñëåäóåò ïðèìåíÿòü òîëüêî ó òåõ ïàöèåíòîâ, ó êîòîðûõ îêàçàëèñü íåýôôåêòèâíûìè âñå êîíñåðâàòèâíûå ìåòîäû. Ó ïîäàâëÿþùåãî áîëüøèíñòâà ïàöèåíòîâ ñ ïëàíòàðíûì ôàñöèèòîì ñèìïòîìû êóïèðóþòñÿ â òå÷åíèå 12 ìåñÿöåâ. Íåñìîòðÿ íà õîðîøèå êðàòêîñðî÷íûå ðåçóëüòàòû, â äîëãîñðî÷íîé ïåðñïåêòèâå õèðóðãè÷åñêèå ìåòîäû ëå÷åíèÿ ñïîñîáñòâóþò ðàçâèòèþ âòîðè÷íûõ ïðîáëåì. Ïåðåä õèðóðãè÷åñêèì ëå÷åíèåì ïàöèåíò äîëæåí áûòü ïðîèíôîðìèðîâàí î âîçìîæíûõ îñëîæíåíèÿõ. |
#34
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zdes bil summary na 1 stranitsu - kuda-to poteryalsya. Potom naydu.
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#35
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[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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#36
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[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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#37
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1 Netter FH. In: Atlas of Human Anatomy. Summit, New Jersey: Ciba-Giegy, 1995:
Plate 500. 2 Kier R. Magnetic Resonance Imaging Studies of Plantar Fasciitis and Other Causes of Heel Pain, MRI Clin North Am 1994;2(1):97–107. 3 Hall-Craggs In: Anatomy as the Basis for Clinical Medicine. Baltimore: Urban and Schwarzenberg, 1990:430. 4 Jahss MH, Kummer F, Michelson JD. Investigations into the fat pads of the sole of the foot: heel pressure studies. Foot Ankle 1992;13:227–32. 5 Hicks J. The mechanics of the foot II. The plantar aponeurosis and the arch. J Anat 1954;88:25. 6 Fuller EA. The Windlass mechanism of the foot. J Am Podiatr Med Assoc 2000; 90(1):35–46. 7 Khan KM, Cook JL, Bonar F, Harcourt P, Astrom M. Histopathology of common tendinopathies. Update and implications for clinical management. Sports Med 1999;27(6):393–408. 8 Gibbon WW, Long G. Ultrasound of the plantar aponeurosis. Skeletal Radio 1999;28(1):21–6. 9 Liddle D, Rome K, Howe T. Vertical ground reaction forces in patients with unilateral plantar heel pain – a pilot study. Gait Posture 2000;11(1):62–6. 10 Berkowitz JF, Kier R, Rudicil S. Plantar fasciitis: MR imaging. Radiology 1991;179: 665–7. 11 Schepsis AA, Leach RE, Gorzyca J, Plantar fasciitis. Etiology, treatment, surgical results and review of the literature. Clin Orthop 1991;266:185–96. 12 Rubin G, Witten M. Plantar calcaneal spurs. Am J Orthop 1963;5:38. 13 De Inocencio J. Musculoskeletal pain in primary pediatric care: analysis of 1 000 consecutive general pediatric clinic visits. Pediatrics 1998;102:E63. 14 Brody D. Running injuries. In: The lower extremity and spine in sportsmedicine. St. Louis, Mosby: 1986:1564–6. 15 Atkins D, Crawford F, Edwards J, Lambert M. A systematic review of treatments for the painful heel. Rheumatology 1999;38:968–73. 16 Crawford F. Plantar heel pain (including plantar fasciitis). Clin Evid 2001;June: 823–31. 17 Lynch DM, Goforth WP, Martin JE, Odom RD, Preece CK, Kotter MW. Conservative treatment of plantar fasciitis: A prospective study. J Am Podiatr Med Assoc 1998;88: 375–80. 18 Gill LH, Kiebzak GM. Outcome of nonsurgical treatment of plantar fasciitis. Foot Ankle Int 1996;17:527–32. 19 Wolgin M, Cook C, Graham C, Mauldin D. Conservative treatment of heel pain: long-term follow-up. Foot Ankle Int 1994;15:97–102. 20 Pfeffer G, Bacchetti P, Deland J, et al Comparison of custom and prefabricated orthoses in the initial treatment of proximal plantar fasciitis. Foot Ankle Int 1999;4: 214–21. 21 Liddle D, Rome K, Howe T. Vertical ground reaction forces in patients with unilateral plantar heel pain – a pilot study. Gait Posture 2000;11:62–6. 22 Katoh Y, Chao EY, Morrey BF, Laughman RK. Objective technique for evaluating painful heel syndrome and its treatment. Foot Ankle 1983;3:227–37. 23 Kogler GF, Solomonidis SE, Paul JP. Biomechanics of longitudinal arch support mechanisms in foot orthoses and their effect on plantar aponeurosis strain. Clin Biomech 1996;11:243. 24 Wapner KL, Sharkey PF. The use of night splints for treatment of recalcitrant plantar fasciitis. Foot Ankle 1991;12:135–7. 25 Batt ME, Tanji JL, Skattum N. Plantar fasciitis: A prospective randomized clinical trial of the tension night splint. Clin J Sport Med 1996;6:158–62. 26 Powell M, Post WR, Keener PT, Wearden S. Effective treatment of chronic plantar fasciitis with dorsiflexion night splints: A crossover prospective randomized outcome study. Foot Ankle Int 1998;19:10–8. 27 Probe RA, Baca M, Adams R, Preece C. Night splint treatment for plantar fasciitis. A prospective randomized study. Clin Orthop 1999;368:190–5. 28 Tisdel CL, Harper MC. Chronic heel pain: treatment with a short leg walking cast. Foot Ankle Int 1996;17:41–2. 29 Gudeman SD, Eisele SA, Heidt RS, Colosimo AJ, Stroupe AL. Treatment of plantar fasciitis by iontophoresis of 0•4% dexamethasone. Am J Sports Med 1997;25:312–6. 30 Crawford F, Atkins D, Young P, Edwards J. Steroid injection for heel pain: evidence of short-term effectiveness. A randomized controlled trial. Rheumatology 1999; 38(10):974–7. 31 Acevedo JI, Beskin JL. Complications of plantar rupture associated with corticosteroid injection. Foot Ankle Int 1998;19:91–7. 32 Speed CA, Nicholls DW, Burnet SP, Richards CA, Hazelman BL. Extracorporeal shock wave therapy in plantar fasciitis. A pilot double blind, randomised placebo controlled study. Rheumatology 2000;39(suppl 123):230. 33 Rompe JD, Hopf C, Nafe B et al. Low energy extracorporeal shock wave therapy for painful heel: a prospective single-blind study. Arch Orthop Surg 1996;115(2):75–9. 34 Rompe JD, Kullmer K, Riehle HM et al. Effectiveness of low energy extracorporeal shock waves for chronic plantar fasciitis. Foot and Ankle Surg 1996;2:215–221. 35 Wild C, Khene M, Wanke S. Extracorporeal shock wave therapy in orthopedics. Assessment of an emerging health technology. Int J Technol Assess Health Care 2000;16:199–209. 36 Sollitto RJ, Plotkin EL. Early clinical results of the use of radiofrequency lesioning in the treatment of plantar fasciitis. J Foot Ankle Surg 1997;36:215–9. 37 Sammarco GJ, Helfrey RB. Surgical treatment of recalcitrant plantar fasciitis. Foot Ankle Int 1996;17:520–6. 38 Stone PA, Davies JL. Retrospective review of endoscopic plantar fasciotomy. 1994–1997. J Am Podiatr Med Assoc 1999;89:89–93. 39 Davies MS, Weiss GA, Saxby TS. Plantar fasciitis: How successful is surgical intervention? Foot Ankle Int 1999;20:803–7. 40 Daly PJ, Kitaoka HB, Chao EYS. Plantar fasciotomy for intractable plantar fasciitis: Clinical results and biomechanical evaluation. Foot Ankle 1992;13:188–95. 41 Fishco WD, Goecker RM, Schwartz RI. The instep plantar fasciotomy for chronic plantar fasciitis. A retrospective review. J Am Podiatr Med Assoc 90:66–9. 42 Yu JS, Spigos D, Tomczak. Foot pain after planter fasciotomy: An MR analysis to determine potential causes. J Comput Assist Tomog 1999;23:707–12. 43. Stiell, 1922. Stiell WF: Painful heel. Practitioner 1922; 108:345. 44. Lapidus and Guidotti, 1965. Lapidus PW, Guidotti FP: Painful heel: report of 323 patients with 364 painful heels. Clin Orthop Relat Res 1965; 39:178. 45 Theodore GH, Buch M, Amendola A, et al. Extracorporeal shock wave therapy for the treatment of plantar fasciitis. Foot Ankle Int 2004; 25:290–297. 46 Mehra A, Zaman T, Jenkin AI. The use of a mobile lithotripter in the treatment of tennis elbow and plantar fasciitis. Surgeon 2003; 1: 290–292. 47 Hammer DS, Adam F, Kreutz A, Kohn D, Seil R. Extracorporeal shock wave therapy (ESWT) in patients with chronic proximal plantar fasciitis: a 2-year follow-up. Foot Ankle Int 2003; 24:823–828. 48 Speed CA, Nichols D, Wies J, et al. Extracorporeal shock wave therapy for plantar fasciitis: a double blind randomised controlled trial. J Orthop Res 2003; 21:937–940. 49 Buchbinder R, Ptasznik R, Gordon J, et al. Ultrasound-guided extracorporeal shock wave therapy for plantar fasciitis: a randomized controlled trial. JAMA 2002; 288:1364–1372. 50 Crawford F, Thomson C. Interventions for treating plantar heel pain. Cochrane Database Syst Rev 2003; (3):CD000416. 51 Rompe JD, Decking J, Schoellner C, Neff B. Shock wave application for chronic fasciitis in running athletes: a prospective randomized, placebo-controlled trial. Am J Sports Med 2003; 31:268–275. |
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#38
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Óâàæàåìûé äîêòîð Sereda Andrey, åùå ðàç ñïàñèáî çà èíòåðåñíûé è ïîçíàâàòåëüíûé ýêñêóðñ â ïðîáëåìó!!!
Ïîäñêàæèòå ïîæàëóéñòà, íåóæåëè öèâèëèçîâàííîå, EBM - îðèåíòèðîâàííîå ÷åëîâå÷åñòâî íàñòîëüêî äàâíî è ïðî÷íî îòðèíóëî äëÿ ñåáÿ ÍÏÂÑ (ìåñòíî è ñèñòåìíûå) ïðè ëå÷åíèè ïëàíòàðíîãî ôàñöèèòà, ÷òî äàæå èññëåäîâàíèé ïî ýòîìó ïîâîäó íå ïðîâîäèëî????? Äåëî, â òîì ÷òî èìåííî ýòè ïðåïàðàòû ñòîÿò â ïåðâîé ëèíèè ëå÷åíèÿ â ËÏÓ, ãäå ÿ òðóæóñü, è ó ìåíÿ â òîì ÷èñëå...(äî ñåãî äíÿ, ïî êðàéíåé ìåðå). Íå ñàì ýòî ÿ ïðèäóìàë, òàê ñòàðøèå êîëëåãè ó÷èëè, òàê ðóññêîÿçû÷íûå ó÷åáíèêè ïî õèðóðãè÷åñêèì áîëåçíÿì ðåêîìåíäóþò (íàïðèìåð "Àìáóëàòîðíàÿ õèðóðãèÿ" ï/ðåä Ãðèöåíêî, Èãíàòîâà); ïîíèìàþ, ÷òî óðîâåíü äîêàçàííàñòè ïîäîáíûõ ðåêîìåíäàöèé íåâûñîê, íî ïîñòóïàë èìåííî òàê.... Òðàäèöèîííî ïðè ïåðâè÷íîì îáðàùåíèè ïàöèåíòà íàçíà÷àë ÍÏÂÑ per os íà 7-10 äíåé (÷àùå ìåëîêñèêàì èëè íèìåñóëèä )+ ÍÏÂÑ ìåñòíî íà òàêîé æå ñðîê (ôàñòóì, íàïðèìåð).... ê ñîæàëåíèþ, íè ðàçó ïàöèåíòàìè ýôôåêò íå îòìå÷åí Èíòåðåñíî, êàêîé ó êîãî ëè÷íûé îïûò â ýòîì îòíîøåíèè, è íàñêîëüêî ýòî ÅÂÌ-îáîñíîâàíî/íå îáîñíîâàíî? |
#39
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Ðàáîòû áûëè. Îäíàêî, íèêòî íèêîãäà â ïåðâóþ ëèíèþ îáåçáîëèâàþùèå ïðåïàðàòû íå ñòàâèë. Âîîáùå ýòî äîáðàÿ îòå÷åñòâåííàÿ òðàäèöèÿ - íàïèñàòü ÷åãî-íèáóäü â ïåðâóþ ëèíèþ áåç îñíîâàíèé.
Äà âîò õîòÿ áû Conservative treatment of plantar fasciitis. A prospective study DM Lynch, WP Goforth, JE Martin, RD Odom, CK Preece and MW Kotter Department of Surgery, Texas A&M University Health Science Center, College of Medicine, Temple, USA. A randomized, prospective study was conducted to compare the individual effectiveness of three types of conservative therapy in the treatment of plantar fasciitis. One hundred three subjects were randomly assigned to one of three treatment categories: anti-inflammatory, accommodative, or mechanical. Subjects were treated for 3 months, with follow-up visits at 2, 4, 6, and 12 weeks. For the 85 patients who completed the study, a statistically significant difference was noted between groups, with mechanical treatment with taping and orthoses proving to be more effective than either anti-inflammatory or accommodative modalities. ... authors concluded that, with or without short-term NSAIDs, mechanical control of the foot is an important factor in the relief of pain from plantar fasciitis. ...  ëè÷íîé ïðàêòèêå ÿ íèêîãäà íå íàçíà÷àë, îäíàêî è íå îòãîâàðèâàë, åñëè ïàöèåíò ñàìîñòîÿòåëüíî õîòåë òàáëýòêó. Ïðîñòî ïðåäóïðåæäàë î âîçìîæíûõ ïîáî÷íûõ ýôôåêòàõ è ãîâîðèë, ÷òî ãëàâíîå - âñå òàêè íå òàáëåòêà. |
#40
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åùå ðåíòãåíîòåðàïèÿ åñòü....
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#41
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Ïðàâèëüíî, åñòü. À âû ìîæåòå íàéòè èññëåäîâàíèÿ ïî ðåíòãåíîòåðàïèè?
Åùå âåäü è êîêàèíîòåðàïèÿ åñòü, òîæå áîëü ñíèìàåò. |
#42
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ïîòîìó è íàïèñàë, ÷òî ðåøèë ñàì ïîèñêàòü êîå-÷òî íà ýòó òåìó.
êàê èñêàë: ïðè íàáîðå ñ ñòðîêå ïîèñêà medline - "radiation therapy fasciitis" âûäàëî "31 documents matched radiation therapy fasciitis", èç íèõ ïî òåìå âñåãî 2 abstract: 1) íåìöû ðàññêàçàëè, êàê îíè ïëàíèðóþò èçó÷àòü ýòó ïðîáëåìó, ðåçóëüòàòû, âåðîÿòíî, ïîÿâÿòñÿ ïîïîçæå.... Randomized multicenter trial on the effect of radiotherapy for plantar Fasciitis (painful heel spur) using very low doses--a study protocol. Radiat Oncol. 2008; 3:27 Department of Radiooncology, Saarland University Hospital, Homburg, Germany. BACKGROUND: A lot of retrospective data concerning the effect of radiotherapy on the painful heel spur (plantar fasciitis) is available in the literature. Nevertheless, a randomized proof of this effect is still missing. Thus, the GCGBD (German cooperative group on radiotherapy for benign diseases) of the DEGRO (German Society for Radiation Oncology) decided to start a randomized multicenter trial in order to find out if the effect of a conventional total dose is superior compared to that of a very low dose. METHODS/DESIGN: In a prospective, controlled and randomized phase III trial two radiotherapy schedules are to be compared:standard arm: total dose 6.0 Gy in single fractions of 1.0 Gy applied twice a weekexperimental arm: total dose 0.6 Gy in single fractions of 0.1 Gy applied twice a week (acting as a placebo)Patients aged over 40 years who have been diagnosed clinically and radiologically to be suffering from a painful heel spur for at least six months can be included. Former trauma, surgery or radiotherapy to the heel are not allowed nor are patients with a severe psychiatric disease or women during pregnancy and breastfeeding. According to the statistical power calculation 100 patients have to be enrolled into each arm.After having obtaining a written informed consent a patient is randomized by the statistician to one of the arms mentioned above. After radiotherapy, the patients are seen first every six weeks, then regularly up to 48 months after therapy, they additionally receive a questionnaire every six weeks after the follow-up examinations.The effect is measured using several target variables (scores): Calcaneodynia-score according to Rowe et al., SF-12 score, and visual analogue scale of pain. The most important endpoint is the pain relief three months after therapy. Patients with an inadequate result are offered a second radiotherapy series applying the standard dose (equally in both arms).This trial protocol has been approved by the expert panel of the DEGRO as well as by the Ethics committee of the Saarland Physicians' Chamber. The trial is supported by a HOMFOR grant (Saarland University Research Grant). ...... |
#43
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2) òóðåöêèå äðóçüÿ ïîïûòàëèñü îöåíèòü âåðîÿòíûé ïîáî÷íûé ýôåêò ðàäèîòåðàïèè - ðèñê êàíöåðîãåíåçà. ëå÷åíèå îöåíåíî êàê ýôôåêòèâíîå. è, êàê ÿ ïîíÿë, ëå÷åíèå íå ïîâûøàåò ðèñê îïóõîëåâîãî çàáîëåâàíèÿ â ïîñëåäóþùåì.
Heel spur radiotherapy and radiation carcinogenesis risk estimation. Radiat Med. 2006 Department of Radiation Oncology, Gulhane Military Medical School, Etlik, 06018 Ankara, Turkey. PURPOSE: Radiotherapy is a nonsurgical alternative therapy of painful heel spur patients. Nonetheless, cancer induction is the most important somatic effect of ionizing radiation. This study was designed to evaluate the carcinogenesis risk factor in benign painful heel spur patients treated by radiotherapy. MATERIALS AND METHODS: Between 1974 and 1999, a total of 20 patients received mean 8.16 Gy total irradiation dose in two fractions. Thermoluminescent dosimeters (TLD(100)) were placed on multiple phantom sites in vivo within the irradiated volume to verify irradiation accuracy and carcinogenesis risk factor calculation. The 20 still-alive patients, who had a minimum 5-year and maximum 29-year follow-up (mean 11.9 years), have been evaluated by carcinogenic radiation risk factor on the basis of tissue weighting factors as defined by the International Commission on Radiological Protection Publication 60. RESULTS: Reasonable pain relief has been obtained in all 20 patients. The calculated mean carcinogenesis risk factor is 1.3% for radiation portals in the whole group, and no secondary cancer has been clinically observed. CONCLUSION: Radiotherapy is an effective treatment modality for relieving pain in calcaneal spur patients. The estimated secondary cancer risk factor for irradiation of this benign lesion is not as high as was feared. |
#44
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èñêðåííå íàäåþñü ÷òî ïîíÿòèå íàøåé äèñòàíöèîííîé ðåíòãåíîòåðàïèè ñîîòâåòñòâóåò èõ ïîíÿòèþ radiation terapy.
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#45
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ïðè íàáîðå â ñòðîêå ïîèñêà "radiotherapy fasciitis" ïîÿâëÿåòñÿ åùå îäíî îïèñàòåëüíîå èññëåäîâàíèå èç Ïîëüøè, áåç ñðàâíåíèÿ ñ àëüòåðíàòèâíûìè ìåòîäàìè. Îïðåäåëåííûé ýôôåêò îòìå÷åí (óëó÷øåíèå ïî÷òè ó ïîëîâèíû ïðîëå÷åííûõ), íà ôîíå ìîåãî îïûòà - ðåçóëüòàòû âïîëíå íåïëîõèå
Àâòîðàìè ëå÷åíèå îïðåäåëåíî êàê ýôôåêòèâíîå. Retrospective evaluation of radiotherapy in plantar fasciitis. Br J Radiol. 2007 Radiotherapy Department, Centre of Oncology, M. Sklodowska-Curie Memorial Institute, Gliwice Branch, ul. Wybrzeze AK 15, 44-100 Gliwice, Poland. Plantar fasciitis is a common painful syndrome that is usually treated by irradiation with a fraction dose (fd) of 1 Gy up to a total dose (TD) of 6 Gy according to clinical experience. By analysing our experiences with numerous former patients, we have attempted to find the relationship between dose and effect. To evaluate the effectiveness of radiotherapy and assess the impact of fd and TD in plantar fasciitis radiotherapy, we assessed 1624 irradiations (856 patients) performed using a fd of 1-3 Gy and a TD of 1-45 Gy. Analysis was carried out on the 623 irradiations (327 patients) for which complete follow-up data were available. The mean follow-up period was 74 months. The following parameters were evaluated: pain relief level; period of anaesthetic effect preservation after treatment; presence of pain and the timing of its appearance; and the intake of analgesic drugs at the last follow-up. After treatment, 48% of the patients reported a lack of pain, 21% reported pain relief greater than 50% and 17% reported pain relief less than 50%. The mean pain relief duration was 72 months. The last follow-up found that pain at rest afflicted 25% of the patients, and pain during walking afflicted 32%. A dose-effect relationship was not found. In conclusion, radiotherapy is an effective treatment for plantar fasciitis. A fd of 1.5 Gy and TD of 9 Gy should probably not be exceeded. |