EFECTOS DE UN PROGRAMA DE REHABILITACIÓN VESTIBULAR DOMICILIARIA EN PACIENTES CON INESTABILIDAD Y ALTERACIONES

En esta tesis doctoral se llevaron a cabo dos estudios. Primero se realizó la validación de la versión en español del cuestionario ABC, concluyendo que es un instrumento válido y fiable para la determinación de la confianza sobre el equilibrio en la realización de actividades de la vida diaria y su aplicación en investigaciones médicas y en la práctica clínica. El segundo estudio fue un ensayo clínico aleatorizado controlado realizado en pacientes con alteraciones vestibulares periféricas unilaterales para comprobar los efectos de un programa de rehabilitación vestibular domiciliaria basado en los ejercicios de Cawthorne-Cooksey de 4 semanas de duración. Los resultados reflejaron que el grupo experimental, comparado con el grupo control, mostró una mejoría significativa respecto al impacto del vértigo sobre la calidad de vida y las actividades cotidianas, así como sobre control postural y en la confianza en su equilibrio para la realización de tareas habituales.Two studies were performed in this thesis. At first, the validation of the Spanish version of the ABC questionnaire was carried out, concluding that it is a valid and reliable instrument, for assessing balance confidence in performing daily life activities and suitable for both medical research and clinical practice The second study was a randomized controlled trial performed on patients with unilateral peripheral vestibular disorders to assess the effects of a 4 week home-based vestibular rehabilitation program based on Cawthorne-Cooksey exercises. Results showed that, compared to control group, a significant improvement on the impact of dizziness on quality of life and daily life activities was observed in the experimental group, as well as on postural control and balance confidence in performing this usual routine activities.Tesis Univ. Jaén. Departamento de Ciencias de la Salud. Leída el 2 de diciembre 2016

Clinical and Cytokine Profile in Patients with Early and Late Onset Meniere Disease

Background: Meniere disease (MD) is an inner ear disorder associated with comorbidities such as autoimmune diseases or migraine. This study describes clinical and cytokine profiles in MD according to the age of onset of the condition. Methods: A cross-sectional study including 83 MD patients: 44 with early-onset MD (EOMD, <35 years old), and 39 with late-onset MD (LOMD, >50 years old), 64 patients with migraine and 55 controls was carried out. Clinical variables and cytokines levels of CCL3, CCL4, CCL18, CCL22, CXCL,1 and IL-1β were compared among the different groups. Results: CCL18 levels were higher in patients with migraine or MD than in controls. Elevated levels of IL-1β were observed in 11.4% EOMD and in 10.3% LOMD patients and these levels were not dependent on the age of individuals. EOMD had a longer duration of the disease (p = 0.004) and a higher prevalence of migraine than LOMD (p = 0.045). Conclusions: Patients with EOMD have a higher prevalence of migraine than LOMD, but migraine is not associated with any cytokine profile in patients with MD. The levels of CCL18, CCL3, and CXCL4 were different between patients with MD or migraine and controls.ISCIII and European Regional Funds (Grants PI17/01644 and PI20/01126)Andalusian Health Government (Grant PE-0356-2018).Andalusian Health Government (Grant PI-0027-2020)

Sociodemographic characteristics of the otoneurology patients at Complejo Hospitalario in Jaén.

Objetivos: conocer la carga de atención esperada y la epidemiología de los pacientes que acuden a la consulta especializada de otoneurología con alteraciones vestibulares o inestabilidad así como su forma inicial de presentación. Métodos: estudio descriptivo transversal en el que se recogen los datos de los pacientes que acuden por primera vez a la consulta de otoneurología en el año 2017 al Complejo Hospitalario de Jaén. Resultados: Fueron remitidos 94 pacientes (50 mujeres y 44 hombres) con una media de edad de 53 ± 11 años. Durante ese año se valoraron 37,9 pacientes por cada 100.000 habitantes. Los pacientes fueron remitidos de las consultas de otorrinolaringología general. El diagnóstico más frecuente fue vértigo posicional paroxístico benigno y enfermedad de Ménière con un 27,6% cada una de ellas seguido de mareo subjetivo crónico con un 22,34%, finalmente el 15,96% de los pacientes habían padecido una neuritis vestibular y solo el 6,38% presentaban migraña vestibular. Conclusiones:Es importante conocer la prevalencia y las características de estos pacientes para realizar una correcta planificación sanitaria en nuestra área de estudio y así prever los recursos sanitarios suficientes.Objectives: The knowledge of the expected attention load and the epidemiology of the patients that come to the specialized otoneurology consultation with vestibular alterations or instability as well as its initial presentation form. Methods: A descriptive transversal study of patients who come for the first time to the otoneurology unit in 2017 at the Complejo Hospitalario de Jaén. Resultados: 94 patients (50 women and 44 men) with a mean age of 53 ± 11 years were referred. During that year, 37.9 patients per 100,000 inhabitants were evaluated. Patients were referred for general otolaryngology unit. The most frequent diagnosis was benign paroxysmal positional vertigo and Ménière's disease with 27.6% each of them followed by chronic subjective dizziness with 22.34%, finally 15.96% of the patients had suffered a vestibular neuritis and only 6.38% had vestibular migraine. Conclusions:It is important to know the prevalence and characteristics of these patients in order to carry out a correct health planning in our study area and appropriate response to the expected care demand in the community