{"id":3233,"date":"2014-06-04T10:58:23","date_gmt":"2014-06-04T10:58:23","guid":{"rendered":"http:\/\/old.institutcataladelpeu.com\/ca\/?p=3233"},"modified":"2016-10-24T07:06:16","modified_gmt":"2016-10-24T07:06:16","slug":"estudi-comparatiu-del-tractament-laser-en-onicomicosi-versus-tractament-combinat-de-laserterapia-i-antimicotic-topic","status":"publish","type":"post","link":"https:\/\/old.institutcataladelpeu.com\/ca\/estudi-comparatiu-del-tractament-laser-en-onicomicosi-versus-tractament-combinat-de-laserterapia-i-antimicotic-topic\/","title":{"rendered":"Estudi comparatiu del tractament l\u00e0ser en onicomicosi versus tractament combinat de laserter\u00e0pia i antimic\u00f2tic t\u00f2pic"},"content":{"rendered":"
\n

En el present estudi ens centrem en la nostra experi\u00e8ncia sobre l’\u00fas del l\u00e0ser com a sistema terap\u00e8utic m\u00e9s actual en el tractament d’onicomicosis, aix\u00ed com els resultats obtinguts mitjan\u00e7ant la sinergia terap\u00e8utica del l\u00e0ser al costat del tractament t\u00f2pic antimic\u00f2tic.<\/p>\n

L’onicomicosi \u00e9s una malaltia infecciosa que afecta l’ungla tant en consist\u00e8ncia com en olor, engruiximent i color. Els principals agents infecciosos s\u00f3n els fongs dermat\u00f2fits (Trichophyton i Microsporum), seguits de llevats (Candida Albicans) i floridures no dermat\u00f2fites (Aspergil\u00b7lus).<\/p>\n

Afecta el 4% de la poblaci\u00f3 mundial i \u00e9s la malaltia unguial m\u00e9s freq\u00fcent als pa\u00efsos desenvolupats. La seva afectaci\u00f3 \u00e9s est\u00e8tica encara que es pot agreujar en grups de risc tals com pacients diab\u00e8tics, immunodeprimits o amb vasculopaties perif\u00e8riques.<\/p>\n

La prevenci\u00f3 es basa en una correcta higiene di\u00e0ria, assecat del peu, \u00fas de mitjons i cal\u00e7at que afavoreixin la transpiraci\u00f3, aix\u00ed com de l’\u00fas d’instruments de tall unguial personalitzats.<\/p>\n

Es classifiquen en cinc grups:<\/p>\n

Onicomicosi subunguial distal i lateral: la m\u00e9s habitual. S\u00f3n infeccions lentes que afecten el color i gruix de la l\u00e0mina unguial.<\/p>\n

–Onicomicosi subunguial proximal: <\/span>la infecci\u00f3 s’inicia a la cut\u00edcula i avan\u00e7a a la vora unguial. \u00c9s poc comuna en individus sans.<\/p>\n

-Onicomicosis distr\u00f2fiques totals:<\/span> d’evoluci\u00f3 lenta, provoquen una hiperqueratosi a l\u2019hiponiqui, aix\u00ed com engruiximent, canvi de color o desvitalizaci\u00f3 unguial total.<\/p>\n

–Onicomicosi blanca superficial:<\/span> com indica el nom, la infecci\u00f3 presenta un color blanquin\u00f3s que envaeix la superf\u00edcie de l’ungla i li provoca un aspecte rug\u00f3s.<\/p>\n

-Onicomicosi candidi\u00e0sica:<\/span> presenta una inflamaci\u00f3 i dolor als canals unguials i degenera en una onicomicosi distal i lateral.<\/p>\n

OBJECTIU DE L’ESTUDI<\/strong><\/p>\n

L’objectiu d’aquest estudi \u00e9s contrastar el grau d’efectivitat del tractament l\u00e0ser en onicomicosi davant de la combinaci\u00f3 del l\u00e0ser i un antimic\u00f2tic t\u00f2pic.<\/p>\n

MATERIALS I M\u00c8TODES<\/strong><\/p>\n

El l\u00e0ser utilitzat en el nostre tractament \u00e9s un l\u00e0ser de longitud d’ona de 1064 nan\u00f2metres i 40 W de pot\u00e8ncia (S 30 Podylas TM) que actua com a antimic\u00f2tic tot respectant els teixits circumdants i sense efectes secundaris.<\/p>\n

L’antimic\u00f2tic utilitzat en el present estudi \u00e9s l\u2019amorolfina al 5% soluci\u00f3. L\u2019amorolfina \u00e9s un fungicida d’ampli espectre del grup de les morolfines. Inhibeix la s\u00edntesi de l\u2019ergosterol i la membrana del fong. T\u00e9 una \u00e0mplia penetraci\u00f3 a nivell de la l\u00e0mina unguial i s’aplica una o dues vegades a la setmana.<\/p>\n

Aquesta investigaci\u00f3 randomitzada ha estat realitzada amb un total de 40 pacients afectats d’onicomicosi per algun dels cinc grups anteriorment descrits. S\u00f3n pacients dels dos sexes dels quals 28 s\u00f3n dones (70%) i 12 s\u00f3n homes (30%). La franja d’edat de les dones compr\u00e8n dels 24 als 84 anys amb una mitjana d’edat de 64 anys, mentre que la franja d’edat dels homes compr\u00e8n dels 36 fins als 76 anys amb una mitjana d’edat de 69 anys. El criteri d’inclusi\u00f3 \u00e9s que siguin majors d’edat. Els criteris d’exclusi\u00f3 comprenen pacients embarassades i pacients tractats d’onicomicosi en els \u00faltims 6 mesos. Tots els pacients participants en aquest estudi han estat diagnosticats d’onicomicosi mitjan\u00e7ant cultiu. Entre els 40 pacients sumen un total de 48 ungles infectades.<\/p>\n

La ter\u00e0pia l\u00e0ser del seg\u00fcent estudi consta de tres sessions d’aplicaci\u00f3 amb un per\u00edode de descans entre sessions de 15 dies. Pr\u00e8via a cada sessi\u00f3, vam fer una neteja exhaustiva de l’ungla infectada. Al grup de pacients amb laserter\u00e0pia combinat amb antimic\u00f2tic t\u00f2pic, se li demana aplicar l\u2019amorolfina des de la primera sessi\u00f3 l\u00e0ser fins a la regeneraci\u00f3 total de l’ungla. Aix\u00f2 significa que hi ha pacients que s’apliquen el tractament durant 3 mesos fins a un m\u00e0xim de 9 mesos (depenent de l’afectaci\u00f3 unguial en profunditat i de la rapidesa a cr\u00e9ixer).<\/p>\n

Hem creat dos grups d’investigaci\u00f3 de 20 pacients cada un:<\/p>\n

-Grup A: pacients (8 homes i 12 dones) tractats nom\u00e9s amb ter\u00e0pia l\u00e0ser i amb un total de 25 ungles infectades. El tant per cent d’afectaci\u00f3 unguial \u00e9s de 4 ungles amb el 25%, 15 ungles amb el 50%, 4 ungles amb el 75% i 2 ungles amb el 100% de la superf\u00edcie.
\n-Grup B: pacients (4 homes i 16 dones) tractats amb laserter\u00e0pia en combinaci\u00f3 amb lamorolfina t\u00f2pica i amb un total de 23 ungles infectades. El tant per cent d’afectaci\u00f3 ungu\u00ecal \u00e9s de 6 ungles amb el 25%, 12 ungles amb el 50%, 2 ungles amb el 75% i 3 ungles amb el 100% de la superf\u00edcie.<\/p>\n

RESULTATS<\/strong><\/p>\n

El grup A (laserter\u00e0pia \u00fanicament) va tenir un \u00e8xit del 76% (19 ungles), mentre que el grup B (laserter\u00e0pia m\u00e9s amorolfina) va aconseguir un \u00e8xit del 86,9% (20 ungles). Les sis recidives del grup A pertanyien a dues ungles amb afectaci\u00f3 del 100%, tres ungles amb el 50% i una ungla amb el 75% de la superf\u00edcie.<\/p>\n

Les 3 recidives del grup B pertanyien a 2 ungles del 100% d’afectaci\u00f3 i 1 ungla del 50%. L’onicomicosi subunguial distal i lateral es va curar en el 96% dels casos en el grup A i en un 95,6% en el grup B.<\/p>\n

CONCLUSI\u00d3<\/strong><\/p>\n

La sinergia entre l’aplicaci\u00f3 l\u00e0ser i el tractament antimic\u00f2tic t\u00f2pic augmenta l’\u00edndex d’efectivitat respecte al tractament amb l\u00e0ser nom\u00e9s. La ter\u00e0pia l\u00e0ser sol ser m\u00e9s activa en onicomicosi subunguial distal i lateral (sortosament la m\u00e9s habitual). El resultat en onicomicosi distr\u00f2fica total \u00e9s de poca efic\u00e0cia, aix\u00ed com nul\u00b7la en els casos d’onicomicosi subunguial proximal, blanca superficial i candidi\u00e0sica.<\/p>\n

En definitiva, la ter\u00e0pia l\u00e0ser demostra ser una bona opci\u00f3 com a tractament antimic\u00f2tic i permet una implicaci\u00f3 menor i m\u00e9s c\u00f2moda per part del pacient en la ter\u00e0pia. Hi ha una variabilitat important d’\u00e8xit depenent del tipus d’onicomicosi i la seva extensi\u00f3.<\/p>\n

\"Estudi<\/a>

L\u00e1ser Podylas S30<\/p><\/div>\n

\"Estudi<\/a>

Aplicaci\u00f3 del l\u00e0ser en onicomicosis<\/p><\/div>\n

\"Estudi<\/a>

Onicomicosis en primer dit<\/p><\/div>\n

\"Estudi<\/a>

Finalizaci\u00f3 del tractament unicament amb laserterapia<\/p><\/div>\n

\"Estudi<\/a>

Onicomicosis de primer dit<\/p><\/div>\n

\"Estudi<\/a>

Finalizaci\u00f3 del tractament unicament amb laserterapia<\/p><\/div>\n

\"Estudi<\/a>

Onicomicosis de primer dit<\/p><\/div>\n

\"Estudi<\/a>

Neteja ungueal abans de iniciar el tractament<\/p><\/div>\n

\"Estudi<\/a>

Finalizaci\u00f3 del tractament amb laserterapia i amorolfina<\/p><\/div>\n

\"Estudi<\/a>

Onicomicosis del primer dit<\/p><\/div>\n

\"Estudi<\/a>

Finalizaci\u00f3 del tractament amb laserterapia i amorolfina<\/p><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

En el present estudi ens centrem en la nostra experi\u00e8ncia sobre l’\u00fas del l\u00e0ser com a sistema terap\u00e8utic m\u00e9s actual en el tractament d’onicomicosis, aix\u00ed com els resultats obtinguts mitjan\u00e7ant la sinergia terap\u00e8utica del l\u00e0ser al costat del tractament t\u00f2pic antimic\u00f2tic. L’onicomicosi \u00e9s una malaltia infecciosa que afecta l’ungla tant en consist\u00e8ncia com en olor, […]<\/p>\n","protected":false},"author":3,"featured_media":6267,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[276,282],"tags":[],"class_list":["post-3233","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-alteracions-dermatologiques","category-articles"],"yoast_head":"\nEstudi comparatiu del tractament l\u00e0ser en onicomicosi versus tractament combinat de laserter\u00e0pia i antimic\u00f2tic t\u00f2pic - Institut Catal\u00e0 del Peu<\/title>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"ca_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Estudi comparatiu del tractament l\u00e0ser en onicomicosi versus tractament combinat de laserter\u00e0pia i antimic\u00f2tic t\u00f2pic - Institut Catal\u00e0 del Peu\" \/>\n<meta property=\"og:description\" content=\"En el present estudi ens centrem en la nostra experi\u00e8ncia sobre l’\u00fas del l\u00e0ser com a sistema terap\u00e8utic m\u00e9s actual en el tractament d’onicomicosis, aix\u00ed com els resultats obtinguts mitjan\u00e7ant la sinergia terap\u00e8utica del l\u00e0ser al costat del tractament t\u00f2pic antimic\u00f2tic. 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Bernad\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"ca\",\"@id\":\"https:\\\/\\\/old.institutcataladelpeu.com\\\/wp-content\\\/uploads\\\/2016\\\/01\\\/MiguelAngelBanosBernad-120x120.png\",\"url\":\"https:\\\/\\\/old.institutcataladelpeu.com\\\/wp-content\\\/uploads\\\/2016\\\/01\\\/MiguelAngelBanosBernad-120x120.png\",\"contentUrl\":\"https:\\\/\\\/old.institutcataladelpeu.com\\\/wp-content\\\/uploads\\\/2016\\\/01\\\/MiguelAngelBanosBernad-120x120.png\",\"caption\":\"Miguel \u00c1ngel Ba\u00f1os Bernad\"},\"description\":\"Director de l\u2019Institut Catal\u00e0 del Peu, professor de la Universitat de Barcelona (ensenyaments de Podologia), responsable de la Unitat Biomec\u00e0nica Oficial de la Federaci\u00f3 Catalana de Tennis, acad\u00e8mic de l\u2019Acad\u00e8mia Internacional de Ci\u00e8ncies i Tecnologia. Posseeix els t\u00edtols de M\u00e0ster i Postgrau en Cirurgia Podol\u00f2gica (UB), Postgrau en Biomec\u00e0nica (UB) i Llicenciatura en Antropologia. Condecorat amb la Gran Creu al M\u00e8rit Acad\u00e8mic atorgada per la AICT el 2011.\",\"url\":\"https:\\\/\\\/old.institutcataladelpeu.com\\\/ca\\\/author\\\/icp\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Estudi comparatiu del tractament l\u00e0ser en onicomicosi versus tractament combinat de laserter\u00e0pia i antimic\u00f2tic t\u00f2pic - Institut Catal\u00e0 del Peu","robots":{"index":"noindex","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"og_locale":"ca_ES","og_type":"article","og_title":"Estudi comparatiu del tractament l\u00e0ser en onicomicosi versus tractament combinat de laserter\u00e0pia i antimic\u00f2tic t\u00f2pic - Institut Catal\u00e0 del Peu","og_description":"En el present estudi ens centrem en la nostra experi\u00e8ncia sobre l’\u00fas del l\u00e0ser com a sistema terap\u00e8utic m\u00e9s actual en el tractament d’onicomicosis, aix\u00ed com els resultats obtinguts mitjan\u00e7ant la sinergia terap\u00e8utica del l\u00e0ser al costat del tractament t\u00f2pic antimic\u00f2tic. L’onicomicosi \u00e9s una malaltia infecciosa que afecta l’ungla tant en consist\u00e8ncia com en olor, […]","og_url":"https:\/\/old.institutcataladelpeu.com\/ca\/estudi-comparatiu-del-tractament-laser-en-onicomicosi-versus-tractament-combinat-de-laserterapia-i-antimicotic-topic\/","og_site_name":"Institut Catal\u00e0 del Peu","article_publisher":"https:\/\/www.facebook.com\/institutcataladelpeu\/","article_published_time":"2014-06-04T10:58:23+00:00","article_modified_time":"2016-10-24T07:06:16+00:00","og_image":[{"width":380,"height":291,"url":"https:\/\/old.institutcataladelpeu.com\/wp-content\/uploads\/2014\/06\/laser-2-20130930_184151-380x291-1.jpg","type":"image\/jpeg"}],"author":"Miguel \u00c1ngel Ba\u00f1os Bernad","twitter_card":"summary_large_image","twitter_creator":"@ICPeu","twitter_site":"@ICPeu","twitter_misc":{"Escrit per":"Miguel \u00c1ngel Ba\u00f1os Bernad","Temps estimat de lectura":"5 minuts"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/old.institutcataladelpeu.com\/ca\/estudi-comparatiu-del-tractament-laser-en-onicomicosi-versus-tractament-combinat-de-laserterapia-i-antimicotic-topic\/#article","isPartOf":{"@id":"https:\/\/old.institutcataladelpeu.com\/ca\/estudi-comparatiu-del-tractament-laser-en-onicomicosi-versus-tractament-combinat-de-laserterapia-i-antimicotic-topic\/"},"author":{"name":"Miguel \u00c1ngel Ba\u00f1os Bernad","@id":"https:\/\/old.institutcataladelpeu.com\/en\/#\/schema\/person\/d2ccc8088f9445f3e2758c2a60caf354"},"headline":"Estudi comparatiu del tractament l\u00e0ser en onicomicosi versus tractament combinat de laserter\u00e0pia i antimic\u00f2tic t\u00f2pic","datePublished":"2014-06-04T10:58:23+00:00","dateModified":"2016-10-24T07:06:16+00:00","mainEntityOfPage":{"@id":"https:\/\/old.institutcataladelpeu.com\/ca\/estudi-comparatiu-del-tractament-laser-en-onicomicosi-versus-tractament-combinat-de-laserterapia-i-antimicotic-topic\/"},"wordCount":1116,"commentCount":0,"publisher":{"@id":"https:\/\/old.institutcataladelpeu.com\/en\/#organization"},"image":{"@id":"https:\/\/old.institutcataladelpeu.com\/ca\/estudi-comparatiu-del-tractament-laser-en-onicomicosi-versus-tractament-combinat-de-laserterapia-i-antimicotic-topic\/#primaryimage"},"thumbnailUrl":"https:\/\/old.institutcataladelpeu.com\/wp-content\/uploads\/2014\/06\/laser-2-20130930_184151-380x291-1.jpg","articleSection":["Alteracions dermatol\u00f2giques","Articles"],"inLanguage":"ca","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/old.institutcataladelpeu.com\/ca\/estudi-comparatiu-del-tractament-laser-en-onicomicosi-versus-tractament-combinat-de-laserterapia-i-antimicotic-topic\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/old.institutcataladelpeu.com\/ca\/estudi-comparatiu-del-tractament-laser-en-onicomicosi-versus-tractament-combinat-de-laserterapia-i-antimicotic-topic\/","url":"https:\/\/old.institutcataladelpeu.com\/ca\/estudi-comparatiu-del-tractament-laser-en-onicomicosi-versus-tractament-combinat-de-laserterapia-i-antimicotic-topic\/","name":"Estudi comparatiu del tractament l\u00e0ser en onicomicosi versus tractament combinat de laserter\u00e0pia i antimic\u00f2tic t\u00f2pic - 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