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Σάββατο, 29 Σεπτεμβρίου 2018 21:00

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OPENDAY

Σάββατο 6 Οκτωβρίου 2018 από τις 9 έως τις 13.

ΘΕΜΑ: Επιστημονική θεώρηση του βελονισμού. Evidence based acupuncture.

Εισηγητής: M. Καράβης, Προέδρος Ελληνικής Ιατρικής Εταιρεία Βελονισμού.

Συμμετοχή ελεύθερη για όλους τους ενδιαφερομένους ιατρούς.

ΠΑΤΗΣΤΕ ΕΔΩ για να δείτε  την διεύθυνση.

 

Κατηγορία Νέα
Τετάρτη, 17 Μαΐου 2017 21:00

Σεμινάρια Βελονισμού 2017-2019

Το Διεθνές Μετεκπαιδευτικό Κέντρο Βελονισμού AcuScience είναι ένα πρότυπο κέντρο οργάνωσης και διεξαγωγής εκπαιδευτικών και μετεκπαιδευτικών προγραμμάτων Παραδοσιακής Κινεζικής Ιατρικής και Ιατρικού Βελονισμού. Ιδρύθηκε το 1989 από μικρή ομάδα ιατρών και σήμερα το εκπαιδευτικό επιτελείο αποτελείται από 13μελή ομάδα ιατρών και οδοντιάτρων διαφόρων βαθμίδων ιεραρχίας και ειδικοτήτων με ειδική εκπαίδευση, μετεκπαίδευση και εξειδίκευση στο Βελονισμό και τον Ηλεκτροβελονισμό.

Στα εικοσιεπτά χρόνια λειτουργίας του Κέντρου έχουν εκπαιδευτεί περισσότεροι απο 860 ιατροί διαφόρων ειδικοτήτων, οι περισσότεροι από τους οποίους ασκούν το Βελονισμό, παράλληλα με την ειδικότητά τους, κυρίως στα ιατρεία πόνου των νοσοκομείων και των κέντρων υγείας, αλλά και στα ιδιωτικά ιατρεία τους.

Η Εκπαιδευτική Ομάδα του Διεθνούς Μετεκπαιδευτικού Κέντρου Βελονισμού έχει δώσει ιδιαίτερη βαρύτητα στη σύγχρονη και επιστημονικά τεκμηριωμένη γνώση. Στη διάρκεια των δύο χρόνων του σεμιναρίου παρουσιάζονται αναλυτικά οι εγκυρότερες και πιο σύγχρονες μελέτες Βελονισμού, με βιβλιογραφικά στοιχεία και πλήρη ανάλυση. Δίδεται ιδιαίτερη έμφαση στην επιστημονική προσέγγιση του Βελονισμού, κυρίως από τη σκοπιά της σύγχρονης ιατρικής γνώσης και έρευνας (evidence based acupuncture).

Σημαντικό μέρος της ύλης του Βιοϊατρικού Βελονισμού που διδάσκεται στο AcuScience, είναι πρωτότυπο και έχει παρουσιαστεί στο Παγκόσμιο Συνέδριο Βελονισμού στην Κορέα (2005), στο Columbia University της Νέας Υόρκης (2009), στα Παγκόσμια Συνέδρια Βελονισμού Σόφιας (2007), Βουδαπέστης (2008), Θεσσαλονίκης (2009), Βιέννης (2013), Βαρκελώνης (2014) και Solothurn Ελβετίας (2014). Επίσης, η επιστημονική ομάδα συμμετέχει σε ειδικά σεμινάρια που διοργανώνει η Ιατρική Εταιρεία Βελονισμού της Δανίας (2006, 2007, 2008, 2012) και φιλοξενεί ομάδες Ευρωπαίων ιατρών που κάθε χρόνο επισκέπτονται την Αθήνα ειδικά για να παρακολουθήσουν την συγκεκριμένη ενότητα σεμιναρίων.

Η καινοτομία  του προγράμματος 2017-2019 είναι ο επανασχεδιασμός του 2ου έτους σπουδών. Οργανώθηκαν εννιά μονοθεματικές ενότητες εξειδίκευσης,  όπως αυτές περιγράφονται αναλυτικά στη σελίδα 3 του ενημερωτικού έντυπου. Οι σπουδαστές θα κληθούν να επιλέξουν επτά (ή το σύνολο) από τις εννέα διημερίδες. Όλα θα ανακοινωθούν, όπως πάντα, στην ώρα τους.

 

 

Ομιλία του ιατρού Καράβη Μιλτιάδη στο 4th Romanian National Congress of Integrative Medicine with International Participation, RO-INMED 2015
 
Διαβάστε το abstract: 
 
There are many issues that make it difficult to conduct a research in order to investigate the efficiency and effectiveness of acupuncture on post-stroke rehabilitation. Series of clinical trials in recent years have shown that acupuncture, as an ancient technique of peripheral sensory stimulation, regulates cerebral microcirculation, cerebral hemodynamics, brain metabolism, focal neuronal activity and function of specific brain regions. Animal studies support also the hypothesis that acupuncture inhibits post-ischemic inflammation, promotes neurogenesis and angiogenesis, increases neurotrophine and BDGF concentration and, as a form of sensory stimulation, induces sensory-dependent neural plasticity. Clinically, there are some reports (small sampled, low quality) that acupuncture improves motor function and balance, upper and lower limb spasticity, self-care ability and quality of life. Furthermore, acupuncture is claimed to be effective in insomnia, anxiety and depression. Finally, some acupuncture points show a specificity on cognitive function (memory, attention, concentration, vocational ability) and their use are considered of great importance on stroke rehabilitation. That is the reasons why we decided to include acupuncture as a commonly used technique in our stroke rehabilitation unit. 
Given the former, in Filoktitis Rehabilitation Centre, Athens-Greece, we conducted (starting from 2011) a preliminary study regarding the effect of TCM acupuncture and electro-acupuncture, on short and long term outcome, in a cohort of 160 patients (86 men (54%) and 74 women (46%), mean age±SD 41.1 ± 16.6 years). The main objective of this preliminary study was to assess the effect of an additional (acupuncture) intervention, in parallel with a routine stroke pharmacological treatment and rehabilitation program, in a sample of subjects with a wide spectrum of neurological conditions, but especially on stroke patients. 
Based on data provided by our experience and the present preliminary study, we aim to assess the effect of electro-acupuncture, TCM acupuncture or a combination of both on a bigger cohort of patients and their short and long term outcomes. The main objectives of this study were the assessment of treatment strategies concerning plasticity of the nervous system, amendment of rehabilitation and improvement of short and long term functional and physical outcomes. 
The design of the present research project (The Filoktitis Research Project) is multidimensional. Basically in order to evaluate baseline characteristics and treatment outcomes in evidence based medicine, we had to use valid and reliable tools. The majority of the scales and questionnaires used in rehabilitation medicine are not validated in Greek language for Greek speaking patients, assessors and clinicians. One of our objectives is to formally translate, adapt and validate key scales and questionnaires in Greek language such as, UK FIM+FAM and modified Ashworth Scale. Furthermore, we aim to assess the test-retest reliability of the scales by examining the inter-rater and intra-rater reliability. Finally, in a randomized-controlled design we aim to evaluate the effect of TCM (combined or not with electro-acupuncture) in big cohort of patients in our rehabilitation Centre.
In this presentation we will present you our latest data and we will share with you the challenges and problems we face in our daily routine using acupuncture in stroke survivors. 
 
 
 
Κατηγορία Νέα
According to American College of Reumatology definition in 1990 (and the latest revision of 2010), fibromyalgia is a clinical, “chronic pain syndrome” mainly characterized  by the presence of widespread and diffuse pain (as the core symptom), that is usually associated with fatigue (more than 90% of patients), morning stiffness, nonrestorative sleep (more than 75% of patients), cognitive dysfunction (fibrofog or brainfog, Glass, 2010), mood disorder (up to 75% of patients) and other somatic complains (IBS, muscular soreness, muscle cramps, Reynaud’s phenomenon, headaches etc). Currently, this syndrome is affecting between 2-4% of population (women 3,7%, Men 0,5%, Denmark 0,7%, Norwegian 10,5%) (McBeth J et al, 2007).  There is strong comorbidity between FM and Chronic Fatigue Syndrome (CFS). These syndromes are considered separate but related disorders, sharing the fatigue (but also unrefreshing sleep, widespread muscle pain and weakness, sore throat, headaches etc) as a common symptom. Fatigue is also the most common symptom of fibromyalgia, second only to the muscle pain and diffuse body aches.
The cause of fibromyalgia is unknown, but some evidence exists about genetic predisposition, HPA and SAM axis dysfunction, DNIC dysfunction, hormonal imbalance etc. Psychoneurobiological dysfunctions are also discussed.
At the 1990’s, the original concept of fibromyalgia was entirely focused on the presence of pain and tender points at specific locations (18 points symmetrically located at both sites of the body). Tender points “were synonymous with fibromyalgia” (Mary-Ann Fitzcharles et al, 2013). Not anymore. American College of Rheumatology (2010) and Canadian Fibromyalgia Guidelines (2012) agreed that the presence of tender points is not of great value and fibromyalgia can be positively diagnosed as a “polysymptomatic distress syndrome” characterized of chronic widespread pain and associated symptoms. Today, due to lack of signs of peripheral inflammation (localize lesions, joint or tissue damage, muscle pathology), we are focus on pain-related and cognitive symptomatology. 
Indeed, many researchers tried to investigate the central component of the disease using fMRI technology in order to localize and describe specific brain areas that are involved in processing of pain signals (Mercado et al, 2013). There are evidence that pain processing abnormalities could be a) due to specific defect in pain matrix (excitatory neurotransmitters, increase of NMDA, AMPA population), and b) close related to the dysfunction of descending opioid and non-opioid pain-inhibitory system (serotonine – norepinephrine – opioidergic pathway). Neuroimaging investigations have found a) abnormal activity within prefrontal and parietal regions (working memory, demanding tasks, control and execution), b) both morphological and functional brain anomalies related to widespread and diffuse pain (fronto-cingulated regions) and c) cognitive symptoms. Many of them support the idea that FM is a real “pain amplification syndrome” characterized of multiple changes into the brain.
Research on peripheral nervous system involvement was less advanced. But recently, a reduction in dermal unmyelinated nerve fibers bundles was found in skin samples of FM patients compared with patients with depression or health controls. This finding supports the hypothesis of impaired small fiber function, towards a neuropathic nature of pain in FM patients (a peripheral, small fiber polyneuropathy) (Nurcan U et al, Brain 2013). A parallel study from US (Oaklander Anne Louise, Pain 2013) also announced that some patients labeled as fibromyalgia had unrecognized small fiber polyneuropathy that was confirmed with distal-leg neurodiagnostic skin biopsies. These results demonstrate that 50% of FM patients may have a “small fiber polyneuropathy” as the main reason for their pains. 
So, the debate between clinicians and researchers regarding the etiological importance of peripheral and central sensitization signs (hyperalgesia, allodynia, hyperpathia, brainfog)   is still open.   
In the present round table we will describe all the above mentioned basic data, in addition with the local, segmental and systemic acupoints that are related with fibromyalgia and chronic fatigue syndrome treatment.  Furthermore we’ll talk about different acupuncture techniques (electroacupuncture, minimal acupuncture, auricular acupuncture etc) and how we’ll choose the appropriate technique according to patient’s history and symptoms. In addition, symptomatic points and points according to TCM etiology of FM/CFS will be analyzed.  
 
Miltiades  Y. Karavis, MD, FICAE, physiatrist
President of Hellenic Medical Acupuncture Society 
 
Bibliography
•Francisco Mercado, Paloma Barjola, Marisa Fernandez Sanchez, Virginia Guerra, Francisco Gomez-Esquer. Brain Function in fibromyalgia: Altered Pain Processing and Cognitive Dysfunction, Madrid, Spain, 2013.
•Glass JM, Cognitive dysfunction in fibromyalgia syndrome. Journal of Musculoskeletal Pain, 2010,  18 (4), 367-372.
•Mary-Ann Fitzcharles MB, Peter A, Ste-Marie BA, Pereira MD, Fibromyalgia:evolving concepts over the past 2 decades, CMAJ, 2013.  
•Nurcan Uceyler, Daniel Zeller, Ann-Kathrin Kahn, Susanne Kewenig, Sarah Kittel-sxhneider, annina Schmid, Jordi Casanova-molla, Karlheinz Reiners, Claudia Sommer. Small fiber pathology in patiens with fibromyalgia syndrome, Brain 2013:136; 1857-1867.
•Wolfe F, Clauw DJ, Fitzcharles M-A et al. The American College of Reumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom Severity. Arthritis Care Res (Hoboken) 2010;62:600-10.
•Wolfe F, Smythe HA, Yunus MB et al. The American College of Reumatology 1990 Criteria for Classification of Fibromyalgia. Report of the Multicenter Criteria committee. Arthritis Rheum 1990;33:160-72.
 
Κατηγορία Άρθρα

Ο κύριος Καράβης προσκεκλημένος στο 6ο Διεθνές Συνέδριο Ιατρικού Βελονισμού στην Βαρκελώνη.

Ομιλία με θέμα: Ινομιαλγία/Σύνδρομο χρόνιας κόπωσης/Βελονισμός
Κλινικό φροντιστήριο: Σύστημα διαχείρισης του stress, ψυχοσωματικές παθήσεις θεράπεια μέσω βελονισμού.

Δείτε το αναλυτικό πρόγραμμα εδώ.

Για την περίληψη της ομιλίας με θέμα την ινομιαλγία πατήστε  εδώ

Για την περίληψη του κλινικού φροντιστηρίου με θέμα το stress πατήστε εδώ.

 

Κατηγορία Νέα