May 14, 2010

¿Qué es un Síndrome?

¿Qué es un Síndrome?


En medicina, un síndrome (del griego syndromé, concurso) es un cuadro clínico o conjunto sintomático que presenta alguna enfermedad con cierto significado y que por sus características posee cierta identidad; es decir, un grupo significativo de síntomas y signos(datos semiológicos), que concurren en tiempo y forma, y con variadas causas o etiologías. Como ejemplo: insuficiencia cardíaca, sindrome nefrótico e insuficiencia renal crónica, entre otras.
Todo síndrome es una entidad clínica, que asigna un significado particular o general a las manifestaciones semiológicas que la componen. El síndrome es plurietiológico, porque tales manifestaciones semiológicas pueden ser producidas por diversas causas.
Si bien por definición, síndrome y enfermedad, son entidades clínicas con un marco conceptual diferente, hay situaciones "grises" en la Patología, que dificultan una correcta identificación de ciertos procesos morbosos en una categoría o en otra.



Como término médico los primeros ejemplos seguros los encontramos en Galeno, s. II d.C., quien cita la palabra reiteradamente como un término propio de médicos empíricos. Galeno documenta la primera aparición de muchas palabras del vocabulario de la medicina a pesar de que él no fue un creador de vocabulario.
Celio Aureliano, médico del Norte de África del s. V d.C. que escribía en latín, tradujo con el término concursus por lo que no aparece la palabra en su forma griega transliterada al latín, es decir, syndrome, hasta el renacimiento.
El primer idioma moderno en que se documenta la palabra es en inglés en una fecha tan temprana como 1541 en una traducción de Galeno de Copland; algunos años más tarde aparece en francés.1




Clasificación Internacional de Enfermedades Codifico al Síndrome de Post Polio con el Código G14 Síndrome Postpolio   Incluye :  Síndrome postpoliomielítico  Excluyéndolo del código B91Secuelas de poliomielitis

May 11, 2010

Expert delivers answers for those inflicted with polio

Expert delivers answers for those inflicted with polio   

Rebuilding Lives, Empowering People and Preventing Injuries

Aninternationally known Post Polio Syndrome expert from the US will give a much-needed insight into the illness during Post Polio Awareness Week (3-9 August).
Dr William DeMayo, Medical Director of the comprehensive Post Polio Clinic at the John P Murtha Neuroscience and Pain Institute in Philadelphia, will share his vast knowledge about Post Polio Syndrome, including its symptoms, side effects and pain management techniques, via a video conference at the Spinal Injuries Association’s Woolloongabba office next Wednesday (5 August).
His talk will centre on the theme, Comprehensive Post Polio Assessment Clinics – do we really need them?
“As Post Polio Syndrome becomes more recognised in both medical circles and in the general community, an increasing amount of people worldwide are being diagnosed with the condition,” Dr DeMayo said.
“I’m looking forward to sharing what I know about the syndrome with a Queensland audience, as I’m aware there are six Post Polio Support Groups operating in regions throughout the state.
“By providing the audience with practical information about the condition, I hope to make a difference in their lives that will assist in easing the disability and pain of Post Polio Syndrome.”
Like most five-year-olds, Varsity Lakes resident Lyn Glover was full of energy, but when she was struck with polio in 1958, she spent a month of solitude while quarantined in hospital recovering from the insidious illness.
Polio did not really feature in Lyn’s life again for many years, until she broke her foot in 2006 and began experiencing the late effects of polio.
To highlight Post Polio Awareness Week (3-9 August), Lyn explains that polio is a viral disease that attacks the spinal cord and causes permanent or temporary paralysis.
“The nerves that were killed or damaged at the time of the initial virus attack when I was young were replaced by the development of compensatory nerves, which resulted in partial recovery,” she said.
“What is now believed to be happening is that those compensatory nerves are dying as the result of over use of muscles and joints and a return for many elderly people with polio to the wheelchairs, calipers and walking canes that many had long discarded.
“Many post polio sufferers are now experiencing considerable pain as the result of this reversal. The condition is called Post Polio Syndrome or known as experiencing the late effects of polio.”
Symptoms are varied but include muscle weakness, extreme fatigue, sleep and breathing difficulties.
The Gold Coast Post Polio Support Group formed in 2007 and Lyn is convenor of the group, which meets monthly to discuss issues ranging from healthcare advice to accessibility issues in the community.
Spinal Injuries Association CEO Mark Henley said it was a real coup for the organisation to host the live video conference with Dr DeMayo.
“Because Post Polio Syndrome and the late effects of polio are still relatively unknown, there are many people in the community with misconceptions, or who may not realise they have one of these conditions,” Mr Henley said.
“Dr DeMayo’s insight into Post Polio Syndrome will answer a lot of questions for many people.”
For more information on Post Polio Syndrome or your local Member Networks group, please visit
Issued 28 July.

Polio gone, but its impact on Albany Creek resident continues.

Albany Creek’s Dr Margaret Peel will later this month attend an international conference on polio survivors in Warm Springs, Georgia – the place where former US President Franklin D Roosevelt, who famously had polio throughout his presidential term, spent a lot of time rehabilitating and passed away in 1945.The Post Polio Health 10th International Conference: Living with polio in the 21st century, will draw approximately 400 people from around the world.Delegates will include those such as Dr Peel who has Post Polio Syndrome (PPS), people experiencing the late effects of polio and medical practitioners from a range of health fields. with polio as a child when the epidemic struck in 1951, Dr Peel spent many years working as a microbiologist and travelling extensively with manageable side effects from her childhood affliction until 10 years ago, when she was diagnosed with PPS

The side effects are different for everyone but can include progressive loss of muscle strength, joint and muscle pain, unaccustomed fatigue, cramping and in some instances, trouble swallowing and breathing,” Dr Peel said.

Increased sensitivity to cold temperatures, difficulty sleeping and a decline in the ability to perform basic daily activities are other symptoms of PPS.

Dr Peel said she would be travelling with several other Australians to the conference and hoped to hear about the latest research being carried out and useful advice on relieving PPS symptoms.

As the secretary of the Brisbane Post Polio Support Group, Dr Peel will then share her conference findings with other members of the group. PPS is still quite unknown in the general community, well-known people who had polio as children include Kim Beazley, John Laws, Janet Powell and the late Kerry Packer and Joh Bjelke-Petersen.

 1921, Franklin D Roosevelt was diagnosed with polio at the age of 39 but that did not prevent him from going on to become President of the United States.He worked tirelessly to fundraise for a polio vaccine and raised more than $25 million for the cause during his time in office.

Spinal Injuries Association CEO Mark Henley said the not-for-profit organisation had six Post Polio Support Groups (PPSG) located throughout Queensland.“Members share their experiences and provide support to each other as they deal with the late effects of polio,” Mr Henley said.“Because the condition is still quite new as the people who had polio in the 1950s begin to age, it can be a daunting time for our members.“Having other people to talk to who are experiencing the same symptoms is reassuring and decreases feelings of isolation and helplessness.“It’s important to remember that polio may be gone from Australia, but its impact on lives continues.”

Clasificación Internacional de Enfermedades Codifico al Síndrome de Post Polio con el Código G14 Síndrome Postpolio   Incluye :  Síndrome postpoliomielítico  Excluyéndolo del código B91Secuelas de poliomielitis

May 9, 2010

Síndrome de Post Polio SPP

Síndrome de Post Polio SPP

Primer Artículo Acerca del Síndrome de Post Polio Publicado
en el Sitio De APPLAC. (2004)
Efectos Tardíos Secundarios de la Poliomielitis (SPP)

E. Liliana Maraco Garrido

En un documento publicado en el año 2004, la Organización Mundial de la Salud reconoce que “Los pacientes con una secuela de poliomielitis paralítica, en particular aquellos quienes tenían mayor edad al inicio de la infección poliomielítica y han tenido una enfermedad inicial severa, pueden presentar años después complicaciones de dolor muscular y una debilidad acrecentada en los miembros afectados: efectos tardíos secundarios o síndrome post-poliomielitis-paralítica
Esta debilidad  neuromuscular y fatiga que se presenta conjuntamente con  intenso dolor ,muchos años después de haber tenido polio se denomina síndrome de post-polio (síndrome SPP).
Padecimiento que ese organismo considera clasificado bajo el código B91 de la ICD-10(Clasificación Internacional de Enfermedades) en el año 2005 la Organización Panamericana de la Salud afirmó que “el síndrome postpoliomielíticoconocido también como secuelas de la poliomielitis y atrofia muscular postpolimielítica, es un conjunto de trastorno que sufren muchas personas que sobreviven a la poliomielitis y suelen aparecer entre 25 y 35 años después del inicio de la enfermedad” La incidencia del síndrome  es del 20-80%  se, considera  que las mujeres tienden a experimentar mas los síntomas de SPP más que los hombres.

Los pacientes inician a observar que sus músculos, inclusive algunos que, según ellos mismos creían, no habían sido afectados por la polio, se debilitan progresivamente, experimentan fatiga, dificultades en la respiración, problemas al tragar (Disfagia), insomnio, apnea, depresión, intolerancia al frío, faciculaciones, dolores en los músculos y las articulaciones, poca resistencia al estrés, dificultades en la capacidad de concentración y memoria. Las investigaciones, según informes médicos, una de las causas son los campos de la inmunología, microbiología, y la más aceptada es el daño y deterioro de las neuronas motoras. Por lo general, el grado de nueva discapacidad depende de la reserva de energía que cada individuo ha tenido en el pasado. En la mayoría de los casos, el SPP avanza en forma gradual, sin embargo en otros casos puede ser abrupta, los especialistas, le denominan “SPP un problema de Alta Frecuencia de Discapacidad”

Durante el ataque inicial de polio, algunas células nerviosas, llamadas células de las astas anteriores de la médula espinal, resultan dañadas o destruidas. Estas células transmiten impulsos nerviosos a los músculos, lo cual permite moverlos según se desee. Sin estos impulsos, un músculo no puede funcionar. Afortunadamente, algunas células de las astas anteriores sobreviven a la polio y envían nuevas conexiones nerviosas a las células del músculo que han quedado desconectadas intentando asumir la función de las células nerviosas que fueron destruidas. Este proceso permite que el paciente recupere el control de sus músculos y su salud. Sin embargo, tras muchos años, estas células nerviosas sobrecargadas pueden comenzar a fallar y causar debilidad muscular nuevamente. Si bien los investigadores no entienden bien cuál es el proceso, muchos creen que los síntomas de SPP son, en parte, la consecuencia de imponer demasiado estrés sobre las células nerviosas que sobreviven a la polio.

Los investigadores no han encontrado ninguna evidencia contundente de que el SPP constituya una reactivación de un virus de polio. Los poliovirus poseen un genoma constituido por ARN y, a diferencia de los retrovirus, carecen de enzimas capaces de transformar ese genoma en ADN. Por todo ello, no podrían establecer latencia en el sistema nervioso por ninguno de los mecanismos que se han identificado hasta hoy en los virus capaces de hacerlo. Salvo datos en contra, se puede decir con fundamento que es muy improbable que los poliovirus puedan permanecer latentes en el sistema nervioso tras la poliomielitis aguda para, décadas más tarde, despertar de nuevo y ser causa del síndrome post-polio (Dra. Pilar León Rega). Sin embargo, como se han encontrado fragmentos virales en algunos individuos con PPS, los investigadores están tratando de determinar si la respuesta inmune del cuerpo ante estos fragmentos contribuye a producir estos síntomas en algunas personas.

Organización Mundial de la Salud.
Organización Panamericana de Salud.
 March of Dimes.
Dra. Pilar León Rega.
Asociación Post Polio Litaff A.C

Clasificación Internacional de Enfermedades Codifico al Síndrome de Post Polio con el Código G14 Síndrome Postpolio   Incluye :  Síndrome postpoliomielítico  Excluyéndolo del código B91Secuelas de poliomielitis


By: Richard Louis Bruno
Published in: NEW MOBILITY, June 1999
Dr. Richard L. Bruno, Chairperson International Post Polio Task Force and
Director of The Post Polio Institute
Englewood Hospital and Medical Center
Englewood, New Jersey 07631
Dr. Nancy M. Frick, Executive Director
Harvest Center, Inc. and
Director of Education
International Post Polio Task Force
After 15 years of searching, archaeologists from The Post Polio Institute have unearthed the "commandments" for treating Post Polio Sequelae (PPS)...
Listen to Yourself!

Polio survivors often turned themselves off from the neck down after they got polio. The first step in treating PPS is to listen to yourself: to what you feel, physically and emotionally, when you feel it and why. Our most powerful tool in treating PPS is the daily logs our patients keep that relate activities to their symptoms.

However, polio survivors sometimes listen too much:
   to vitamin salesmen saying some herb or spice will "cure" PPS,
   to other polio survivors who warn that you will eventually have every
     possible PPS symptom,
   and to friends and family members (and the voices in you own head) 
    saying you're lazy and that you must "use it or lose it."
Polio survivors need to listen to their own bodies, not to busy bodies.

Activity is not Exercise!
Polio survivors believe that if they walk around the block five times a day, spend an hour on the exercise bike and take extra trips up and down stairs, their muscle weakness will go away. The opposite is true: the more you overuse your muscles the more strength you lose. Muscles affected by polio lost at least 60% of their motor neurons; even limbs you thought were not affected by polio lost about 40%. Most disturbing is that polio survivors with new muscle weakness lose on average 7% of their motor neurons per year, while survivors with severe weakness can lose up to 50% per year! You need to substitute a "conserve it to preserve it" lifestyle for the "use it or lose it" philosophy. Stretching may help pain and non-fatiguing exercise for specific muscles can prevent you from losing the strength you have after you get a brace. But polio survivors need to work smarter, not harder.

Brake, Don't Break.
The follow-up study of our patients showed that taking two 15 minutes rest breaks per day - that's doing absolutely nothing for 15 minutes - was the single most effective treatment for PPS symptoms. Another study showed that polio survivors who paced activity -- that is worked and then rested for an equal amount of time -- could do 240 percent more work than if they pushed straight through. Our patients who took rest breaks, paced activities and conserved energy had up to 22% less pain, weakness and fatigue. But polio survivors who quit or refused therapy had 21 percent more fatigue and 76% more weakness.

For polio survivors, slow and steady wins the race.

A Crutch is Not a Crutch...
...and a brace is not a sign of failure or of "giving up." You use three times less energy (and look better walking) using a short leg brace on a weakened leg. Overworked muscles and joints hurt and nerves die after decades of doing too much work with too few motor neurons. So why not use a brace, cane, crutches (dare we say a wheelchair or a scooter) if they decrease your symptoms and make it possible to finally take that trip to Disney World? We know, you'll slow down and take care of yourself "when you're ready." And you'll use a wheelchair "when there's no other choice." Well, you don't drive your car until it's out of gas. Why drive your body until it's out of neurons?

Just Say "No" to drugs, unless...
Five studies have failed to find that any drug that treat PPS. And there have been no studies showing that herbal remedies or magnets reduce symptoms. Polio survivors shouldn't think that they can run themselves ragged, apply a magnet or pop a pill, and their PPS will disappear. Pain, weakness and fatigue are not-so-subtle messages from your body telling you that damage is being done! Masking symptoms -- with magnets or morphine -- will not cure PPS.

However, two studies have shown that polio survivors are twice as sensitive to pain as everyone else and usually need more pain medicine for a longer time after surgery or an injury (see 10 below).

Sleep Right All Night.
The majority of polio survivors have disturbed sleep due to pain, anxiety or sleep disorders, such sleep apnea (not breathing) or muscles twitching and jumping all over your body during the night. However, polio survivors are usually not aware that they stop breathing or twitch! You need a sleep study if you awaken at night with your heart pounding, anxiety, shortness of breath, choking, twitching, or awaken in the morning with a headache or not feeling rested. "Post polio fatigue" may be due to a treatable sleep disorder.

Some Polio Survivors Like it Hot.
Polio survivors have cold and purple "polio feet" because the nerves that control the size of blood vessels were killed by the polio virus. Actually, polio survivors' nerves and muscles function as if it's 20 degrees colder than the actual outside temperature! Cold is the second most commonly reported cause of muscle weakness and is the easiest to treat. Dress in layers and wear socks made of the silk-like plastic fiber polypropylene (sold as GORTEX or THINSULATE) that holds in your body heat.

Breakfast Is the Most Important Meal of the Day.
For once Mom was right. Many polio survivors eat a Type A diet: no breakfast, coffee for lunch and cold pizza for dinner. A recent study shows that the less protein polio survivors have at breakfast the more severe their fatigue and muscle weakness during the day. When our patients follow a hypoglycemia diet (have 16 grams of low-fat protein at breakfast and small, non-carbohydrate snacks throughout the day) they have a remarkable reduction in fatigue. Protein in the morning does stop your mid-day yawning.

Do Unto Yourself as You Have Been Doing For Others.
Many polio survivors were verbally abused, slapped or even beaten by therapists or family members when they had polio to "motivate" them to get up and walk. So polio survivors took control, becoming Type A super-achievers, "the best and the brightest", doing everything for everyone except themselves. Many polio survivors do for others and don't ask for help because they are afraid of being abused again. Isn't it time that you got something back for all you've done for others? Accepting assistance is not the same as being dependent. Accepting assistance can keep you independent. But appearing "disabled," by not doing for others, asking for help or using a scooter, will be frightening. Remember: If you don't feel guilty or anxious you are not taking care of yourself and managing your PPS.

Make Doctors Cooperate Before They Operate.

Polio survivors are easily anesthetized because the part of the brain that keeps them awake was damaged by the polio virus. Polio survivors also stay anesthetized longer and can have breathing trouble with anesthesia. Even nerve blocks using local anesthetics can cause problems. All polio survivors should have lung function tests before having a general anesthetic. Your complete polio history and any new problems with breathing, sleeping and swallowing should be brought to the attention of your surgeon or dentist - and especially your anaesthesiologist - long before you go under the knife. Polio survivors should NEVER have same-day surgery or outpatient tests (like an endoscopy) that require an anesthetic.

The Golden Rule for Polio Surviors:
If anything causes fatigue, weakness, or pain, Don't Do It! (or do a lot less of it.)
. . . and . . .
The Golden Rule for Polio Survivors' Friends & Family:
See no evil, hear no evil... and help only when asked.
Polio survivors have spent their lives trying to look and act "normal." Using a brace they discarded 30 years ago and reducing their super-active daily schedule is both frightening and difficult for them to do. So, friends and family need to be supportive of life-style changes and accept survivors' physical limitations and new assistive devices. Most important, friends and family need to be willing to do the physical tasks a polio survivor should not do, but only when the polio survivor asks. Friends and family need to know everything about PPS but say nothing: neither gentle reminders nor well-meaning nagging will force survivors to use a new brace, sit while preparing dinner or rest between activities. Polio survivors must take responsibility for taking care of themselves and ask for help when they need it.

Clasificación Internacional de Enfermedades Codifico al Síndrome de Post Polio con el Código G14 Síndrome Postpolio   Incluye :  Síndrome postpoliomielítico  Excluyéndolo del código B91Secuelas de poliomielitis

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